Adverse Conditions
by fluffy2001
Summary: The sequel to A House Assessment. Chase is left in charge of his first case as an attending when House goes on an impromptu vacation. Everyone involved is less than cooperative and Chase is forced out of his comfort zone.
1. Chapter 1

Author's note: By popular demand, I offer a sequel to A House Assessment showing Chase's first case as an attending. This story will focus on how I see him reacting to being in charge, so hopefully it won't disappoint.

**Time for the standard disclaimer: I do not own any of the characters except Estelle. **

The warning signs were all there. Somehow Chase got through his first day as an attending unscathed but not having a case probably helped. He didn't feel so lucky today. House was planning something devious. He knew his tormenting boss was waiting for the right opportunity to throw him under the bus. He had a feeling the page from the ER would deliver the right opportunity.

"You paged me?" Chase inquired to the head ER nurse on duty.

"Yes Dr. Chase," replied the nurse. "We have a doozy for you."

In an open corner of the very hectic room laid a noticeably overweight older white woman. She was unconscious but stable for now. She hadn't been stable for long though and her problems were in multiples.

"She came in a few hours ago. She didn't show up for work, which apparently was something she never did. A co-worker had the super check on her and he found her in a recliner unresponsive. You'll never believe what we have found so far." The nurse handed him the chart.

Chase opened the file and his eyes bugged out of his head. "How is she still alive? Her vitals are all over the map." He couldn't understand how a person's systems could all be in such distress without any of them failing yet.

"Why do you think we called you?" replied the nurse. She then moved a bit closer to Chase and starting talking in a lower voice. "To be honest, no department was thrilled more with your promotion than us. Now we don't have to go through House. That and all the nurses think you are prettier to look at."

Chase looked over at the desk to see a few nurses staring at him. They started giggling when they caught him glancing in their direction.

Chase smiled. "Cute," he said.

Despite all the nice distractions, Chase quickly turned his attention back to the patient. "So we have no idea why she is still unconscious, but yet there are plenty of reasons why. She has too many meds in her system right now, so I'm reluctant to start her on anything. Get her up to ICU and have them page me if anything changes. She's stable for now, so we'll go from there."

"Yes Dr. Chase," the nurse replied.

He took the file and went off to inform the team about their latest case.

-----------------------

Cameron and Foreman sat contently in the diagnostic conference room reading the paper and enjoying their morning coffee.

"Where's Chase?" House shouted from his office where he was tucked away from the others.

"He had an emergency," Cameron replied as she kept her head buried in her morning source of information.

House wasn't ready to surface yet. Chase needed to be there.

A few minutes later Chase strolled into the conference room not amused by the fact that his colleagues were having a calmer morning than he was. "We have a case," he said as he threw the file down on the table. "Estelle Anderson, white female, 58 years old. She came into the ER a few hours ago and is on her way up to ICU. Her file will blow your mind."

Cameron grabbed the file and started reading. "Wow. Blood pressure is through the roof at 180/110, pulse rate is barely at 30, ekg is erratic, breath sounds on both sides are weak, kidney and bladder function are not normal, EEG shows some brain abnormalities but nothing life threatening. Here is one cause of her symptoms; she's 320 lbs."

She paused a minute to read further into the scattered test results before dictating the rest. "Whoa, look at the amount of prescription drugs in her system. There must be 20 different kinds of chemicals in her."

"At least," responded Chase. "There are other substances too, so it is my guess she was taking over the counter drugs as well."

After taking another minute to study the file, Cameron reached her conclusion. "It looks like her body is shutting down. She's a mess."

"That's what makes this case interesting," observed Chase. "Her body isn't shutting down. It is more like each system is fighting with one another. She's battered, but not failing yet."

House saw his moment of opportunity now to barge in. "Who gave you the authority to take cases without my approval?" he said directly at Chase. "Oh, that's right, I did."

House was eager with anticipation as he turned to address all three of his underlings. "Anyway, since you are all here, I have an announcement to make. I'm taking a week's vacation, starting now." he said looking at his watch.

"Where are you going?" asked Cameron.

"Not sure," replied House.

"Whose going to run the ca..?" Cameron stopped herself at the last second as she realized the answer.

They all looked at Chase. "The diagnostic attending in charge during my absence, that's who," said House. "I love having another attending around to cover for me. This will be the best vacation ever."

House handed Chase a white board marker and headed toward his office. "I'll make sure to send you all a postcard. I'm not taking my pager either."

The ducklings all looked at each other with surprised glances, but they weren't too surprised. After all, this was House. He was up to something, and it looked like Chase was the benefactor of his latest stunt.

"Okay, whatever," Foreman said in reaction to House's antics this time. "My advice is to write small on that board. There a lot of symptoms here." he said to Chase as he read the file.

"Nothing is going on that white board yet," replied Chase as he put back the marker. Cameron and Foreman looked at him like he was creating a mutiny.

Chase went on to explain his reasoning. "If she has this many prescription drugs in her system, and several other substances by the looks of it, she likely has a few doctors who prescribed them. She must have a few conditions that we don't know about. We need to get a history and figure out how she got here. Who wants to talk to her son? He's on his way."

"Sorry, I've got a consult," said Foreman as he checked his silent pager and left.

Chase looked at Cameron. "Clinic duty," she said and quickly followed Foreman.

Chase knew her clinic duty was later this afternoon, but he let her go anyway. The dreaded moment was upon him. His uphill battle had begun.

--------------------------

"Mr. Anderson," Chase said to a young man in his thirties waiting in a private area. I'm Dr. Chase. I'm in charge of your mother's case."

"What's wrong with her?" the young man asked as they both sat down.

"We don't know. There are a number of things wrong with her. We just aren't sure what's causing her condition." Chase said directly.

The son didn't seem to be shocked at all by that comment. "Yeah tell me about it. She has been checked out for every condition and disease known to man. I'm sure her doctors have looked for some unknown things as well."

Chase was rather curious about this man's indifference to his mother's issues. "Do you know which doctors she is seeing and what she is being treated for?"

"I have no idea. She calls me almost daily talking about a visit to this doctor or that doctor and what they think she has this time. I never knew what the actual problem was since she never told me if she was officially diagnosed. I only ever heard the words "they think" then she would move onto something else the next time. It was my guess that none of it was real and she just liked going to doctors for company."

"What were some of the problems she mentioned?" asked a curious Chase.

"Diabetes, breast cancer, hormonal imbalance, slipped disk, osteoporosis, arthritis, cataracts, high blood pressure, heart disease, anemia, allergies, fluid in ears, migranes, muscle weakness, carpal tunnel, sleep apnea, bladder issues, fibromyalgia, severe depression…"

Chase interrupted him after the last item mentioned. "She had mental health issues?"

"Yeah, that was another thing that always came up. Those problems I believe since she hasn't been quite right my entire life. No one doctor could ever figure out her mental health problems either. One time it was OCD, then when the treatment for that didn't work it changed to GAD. Once that didn't get better they moved onto severe depression and she had alternated between one anti-depressant after another. None seemed to do the trick. The latest quack said she had adult ADD."

Chase at first tried to write notes, but stopped. There was no way he was going to be able to get all this down quickly, and he was way too interested by the story this man was telling. "Does she have trouble concentrating? That is usually a sign of all those conditions."

"Hell yes, all the time. Her brain is so weird. She can't remember the time for a doctor appt or to pay her bills, yet she will tell me with great detail the items she had on the seafood buffet five years ago. As you can tell, she loves to eat."

Chase nodded and tried to process where to go next with his line of questioning. "Okay, aside from the mental health problems, is there anything you know for sure that she has?"

"She has had thyroid problems her entire life. She is on medication for that. Also, she had complications when she was pregnant with me. She and dad tried for seven years to get pregnant and once she did it wasn't a good one. Apparently she almost died. I don't know the whole story though since neither of them wanted to talk about it. I know she had a hysterectomy after I was born."

"Is your dad deceased? I don't see a mention of a spouse anywhere in her chart." asked Chase.

"No dad's alive. Four years ago one afternoon mom just packed up the car and left. She didn't say a word to my dad indicating anything was wrong. He was so mad that he didn't talk to her, so the divorce was handled through me."

Chase stopped for a moment to rub his forehead. Was this man actually telling the truth? Sadly, yes, he believed he was. "Okay, let's go back to her medical history. Is there any other problem or accident that has happened to her?"

"Accidents?" Mr. Anderson perked up like the magic word had been uttered. "You aren't going to have enough room in that chart for her entire accident history. One story I grew up hearing from relatives was when she was a teenager she fell down the stairs and had a head injury. In my lifetime she has numerous workplace accidents on her record. Mostly slips and falls, but she was in food service for ten years and constantly had problems with burns and cuts. Worker's comp won't even grant claims anymore because of too many pre-existing incidents/conditions. She has broken several bones by just banging into something around the house. Recently her toes were breaking for no apparent reason. She has also been in several car accidents."

"Any serious injuries?" asked Chase.

"To the cars, yes, several have been totaled. Another than a banged up body though, she has always recovered."

"The ER nurse mentioned a co-worker. Is she is still working?"

The young man started laughing. "Yes, doing the most absurd thing a woman in her condition should be doing. She is a nursing aide in a nursing home. She spends all day doing a physically demanding job that she is not capable of doing. I don't know why this place doesn't fire her. My guess is because she didn't sue after her last workplace accident. She has to work though. She lives in poverty now. If she didn't work she'd be on the street."

Chase had seen his fair share of children who were cruel and negligent to their parents. He always bit his tongue, but he really felt like slapping this jerk. As usual though, he restrained. "Is there anything else?"

Mr. Anderson paused trying to think of what moment he should share next. "Oh, she has trouble sleeping. She is up several times and night and I don't think has gotten 8 hours in years. Her weak bladder forces her to get up and go to the bathroom a lot. Also, she is a chronic pill popper."

This time Chase heard his magic word. "What type of pills does she take? How many a day?"

"Anything the GNC carries. She will get a twinge somewhere and all it takes is some lady at work telling her about the latest vitamin or herb that helps the pain and she gets it. She will take a pill without hesitation and not worry if it might cause problems with the other stuff she is taking. She recently has gotten into buying supplements in bulk. She found an Internet site that does buy one get two free. She has boxes of these bottles stacked underneath all the other junk that litters her apartment."

"She has a messy place?" Chase asked knowing they were going further into the quagmire with that question.

"She is easily the worst housekeeper in the world. Growing up was shameful. I couldn't invite friends over because the place looked like an atomic bomb had hit it. We could never find anything."

"Has she been diagnosed for Hoarding?"

"I'm not sure what they call it, but if Hoarding involves not throwing a single thing away, buying lots of stuff in stores and yard sales compulsively, and stacking all that junk everywhere in your home then yes, she has that too."

"Okay," Chase said trying to get some focus. He had a feeling that there was a lot more to be learned but he was suffering from too much information. More details would have to be gotten later. "I need a list of the doctors she has been seeing. We need to see her medical records."

Mr. Anderson fished in his pocket, pulled out a set of keys, and then proceeded to take a single key off the ring. He handed it to Chase. "Have at it. You have my full permission to go on an expedition through her apartment and see if you can find that info. You will likely find what you need through her unread mail containing all her unpaid doctor bills. I'm not going anywhere near that pig sty."

Chase took the key and stared with disbelief at this completely insensitive bastard. He was making House look like a saint. "Thanks, I'll let you know what I find." He left Mr. Anderson behind to continue waiting.

As he was walking back to the conference room Chase had to admit having permission to perform a search was a big plus on his first case. No breaking and entering rap on his watch. House would be so disappointed in him though.

--------------------------

Chase got back to the conference room, dropped the file on the table, and took a deep breath while running his right hand through his disheveled blonde hair. He looked at the empty white board. _How in the world was he going to plow through this mess?_ He thought. Then he heard a noise coming from House's office. He went in to see what was going on.

"House, why are you still here?" Chase asked. House was sitting at his desk, feet up, leaning back and listening to the ipod through headphones with his eyes closed.

"I'm on my flight to Cancun. The music helps me relax since I don't like flying to much." House replied.

Chase got very agitated and finally figured out what House was up to. "You're staying here in this office all week, aren't you? You want to spy on me."

"Cancun is lovely this time of year. The part I'm looking most forward to is the babes in bikinis." House replied obviously not acknowledging Chase's comment.

"Fine, listen in. You will be bored all week." Chase snapped as he exited the office.

A huge devilish smile appeared on House's face. This was going to be a great vacation.


	2. Chapter 2

Chase was so absorbed in the task of writing up the case notes that he didn't hear Cameron and Foreman enter. It looked to them as if he were trying to create a novel. Then Cameron glanced into House's office and saw House in the same position that Chase discovered him in earlier.

"What's he still doing here?" asked Cameron with bewilderment.

"Don't ask," said a still aggravated Chase.

Foreman then got a huge smile on his face. "I get it now." He started laughing and shouted into the other room, "Good one House!"

"Enough about him," said a disgruntled Chase. "I have some more info to discuss."

They all sat down at the table to discuss the case. "What did you find out?" asked Cameron.

"I don't know where to begin," answered Chase. "It will take me hours to write up the history the son gave me. She has had every problem under the sun, seems to have visited every doctor in town and others elsewhere too, and she takes pills like candy anytime she has a slight pain which is often."

"Hmm, the pill popping sounds familiar," Cameron said loudly toward House's office. "Did the son know what doctors she was seeing?" Cameron asked.

"He had no clue, and wasn't very interested in finding out. He seems to think his mother is a hypochondriac. He did however give me this." Chase held up the apartment key he received.

"A key will make the break-in easier," said Foreman.

"This time there is no break-in. The son gave me his full consent. For once, our search will be legal."

"You idiot!" rang from a voice in the adjacent room. Everyone wisely chose to ignore it.

"I'm really going to need some help here," said Chase. "She apparently is a Hoarder. Searching through piles of trash in a tiny apartment could provide an interesting treasure hunt. This will be a chance for all of us to search a residence together."

Cameron and Foreman looked at each other, both working on excuses in their minds as to how to get out of this one.

"Sorry, clinic duty," said Cameron as she got up to leave.

"I thought your clinic hours were this morning," said Chase.

"Uh, I have to cover for House. See ya." She quickly slid out the door.

Chase looked at Foreman. He opened his mouth but before a word got out Chase interrupted him. "I know, consult."

"Glad you understand," said Foreman with a smile and patted Chase on the back as he made his quick exit.

Chase sat at the table alone. He should have expected this. He and Cameron weren't any more cooperative when Foreman was in charge. He was just going to have to suffer through this. _Cameron's turn can't come soon enough, _he told himself.

As Chase grabbed his coat and bag for his visit to Estelle's apartment, he shouted to House, "I heard a hurricane is headed toward Cancun. This is an excellent time for you to become a missing person."

House got a huge smile of pride. _When it comes to put downs, I trained them right, _he thought.

-------------------------

Chase had never been to this part of town before. As he drove through the neighborhood, he perceived it to be a community that had been long forgotten but they were trying to make the best of it anyway. The homes were very small and modest, but the new brick sidewalks, black wrought-iron old fashioned street lamps and updated landscaping showed that they were trying to emit some pride amidst the humble circumstances.

Any sense of pride and community abruptly ended as soon as he turned into the complex where Estelle lived. The place was a squalid dump. Trash littered the parking lot and significant vegetation grew through the cracks of the long neglected pavement. The dwellings were old brick buildings that from the exterior showed the years of water erosion and damage from the elements. The windows had so much dirt caked on them that he doubted that much sunlight actually worked their way through them. That is the windows that weren't boarded up.

He parked his car next to the back entrance. Estelle lived on the bottom floor near that entrance. He approached the doorway and noticed a security keypad, but the door lock had been bashed in so many times its purpose was lost. He then looked to the left to see a dumpster and a homeless man enjoying an afternoon rest.

Chase opened the battered door and as he stepped inside the foul stench of urine hit him in the face. He could tell that the foyer had become a makeshift bathroom for some, or at least the guy outside. He went down about five steps still choking on the smell to the hallway where the apartments were. The carpeting that covered the area was grossly stained and almost worn to nothing in places. He could tell a few of those stains were water related.

Estelle's apartment was easy to find as it was the first door on the right. The door contained a flimsy lock in the doorknob and no deadbolt which made using the key almost unnecessary. Chase entered the tiny apartment to find it indeed looked like an atom bomb went off. The place was packed so hard with clutter he could barely move. Yet again, he was hit in the face with more awful smells, although the ones he experienced this time were different and seemed to be from more than one source.

The kitchen sat to the left and the main living room was straight ahead. Chase first checked the kitchen where counters were packed tight with clutter. There were bags and bags of junk food, canned goods, packages of ramen noodles and so many bottles of spices that he couldn't imagine a restaurant going through them all let alone one person. The sink was stacked full of dishes that hadn't seen water in weeks. There was one identifiable source of the bad smell.

Next he entered the living area. The piles of boxes on both sides of him offered a small little walkway. The carpet, in which only a very small part was visible, was piled with dirt and dust and obviously hadn't been cleaned in years. He also noticed that absolutely everything was covered with a significant layer of dust. The dust along with the smell made the air quality unbearable. The couch, the dining table, end tables, and bookshelves all were packed with stuff as well as the floor. He noticed stacks of loose papers and tons of shopping bags everywhere. He looked at one of the piles to find one dollar or drug store item after another stuffed in a bag and thrown on top of one another. That seemed to be representative of most of the piles in the apartment. The only piece of furniture that did not contain any litter was the recliner.

To the left of the main living room was a bathroom and a bedroom. The bathroom offered the next powerful odor, and it was the worst yet. Chase walked in and pulled back the shower curtain that lined the bathtub. The tub was packed full of rotting garbage that had been there a long time. He thought he was going to get sick. He could handle anything disgusting with the human body, but rotting trash was a different story. It was time to get out the hospital mask.

He turned to the medicine cabinet sitting on the wall next to the tub, opened it, and found it packed full with a wide array of prescription drugs. He pulled the bottles out one by one and put each in his bag, noticing a different doctor's name on all of them. Some were old and expired, but most were very recent. He put about 20 bottles into his bag.

Chase knew that this couldn't be all she was taking. He wandered over a linen closet tucked away next to the bathroom. When he opened that door, overpowering stench number three appeared. The smell was very musty. Another huge offering of pills lined the front part of the shelves and blankets, sheets, towels and other items were packed tightly right behind them. He grabbed the bottles and put them into his bag with the others. These drugs were mostly over the counter medicines, but there were some more prescriptions as well.

Curious about the source of the stench, Chase pulled out the contents of one of the shelves. "Oh my god," he said in reaction to his discovery. Covering the entire back and right side of the closet were black spores indicative of dangerous mold. There was likely a leak in the wall at some point that Estelle never noticed behind all the junk.

Chase walked into the bedroom where the other side of the moldy closet was. Surely mold had to be there as well. He found another pile of junk stacked to the ceiling against that wall and that sat next to a large dresser. He pushed over the pile, accepting that he couldn't be making any bigger a mess. As the items toppled over, he noticed black spotting all over them. The wall the pile previously leaned on was completely black, as well as the back of the dresser. He scraped a sample from the wall, bagged it, and then made a phone call on his cell.

"Yes, my name is Dr. Robert Chase. I'm in apartment 103. I need a building manager here now. We have a serious health problem here."

_How in the world can anyone live like this? Especially in this country?_ Chase asked himself. He had seen some very impoverished parts of the world upon his travels but had never seen living conditions like this.

While waiting for the manager he tried to look around some more. He looked at all the junk that covered the bed. Obviously Estelle never slept in the bed. The only used piece of furniture was the recliner, so that must have been the bed as well. There he found the boxes and boxes of health supplements her son mentioned. He opened them up. Shark Cartilage, B Vitamins, Ginkgo Biloba, Bee Pollen, St. John's Wort, Multivitamin, Glucosamine Chondroitin, Calcium Carbonate, Magnesium Oxide, Ephedra, Ma-hong, Echinacea, Lycopene, Progesterone, Melatonin, Selenium… and he just couldn't take looking anymore. He would just load these boxes into his car and analyze the products in the lab.

Next to the cluttered bed was an even greater cluttered desk. Stacked on the desk were piles of mail. Many were doctor bills and unopened insurance statements as the son predicted. There were also several letters marked as a third or final notice. Chase grabbed all the medical related letters and forced them into his already overstuffed bag.

About twenty minutes later, after Chase had taken time to load items into his car and do a little more searching for medical records, the building manager entered. "Can I help you?" he asked Chase.

"Yes, follow me," said a very unimpressed Chase with this man's building management skills. He took him to the closet. "You have a very serious mold problem here. Judging by the source, this can't be just happening here."

"Not again," said the man as he looked at the damage. "I thought we had this all cleared up. Several months ago an apartment on the top floor had a pipe burst. We cleaned up that one and the one above this unit."

"Those were the only ones you checked?" asked Chase. "Standard procedure has you checking every residence in the building."

"Look, people don't complain for a reason here. The rent is very cheap and they want it to stay that way." replied the manager.

"That's why you let Mrs. Anderson live like this? This place should be condemned!" Chase told the man angrily.

"It was her business. She pays the rent, so we are fine with it."

"Let's see how fine you are with it when I call the Board of Health." Chase grabbed the final box to be loaded and left. This was easily the most disturbing home search he had performed yet.

----------------------------------

_Mycotoxosis_. That was the very first item Chase wrote on the white board when he got back from his search. Now it was time to sort out the rest.

He started going through the mail pile. Between that and the pills he found, he should be able to piece together a good chunk of the history. The mail revealed that Estelle was under the care of 28 specialists and one general practitioner. She was thousands of dollars in medical debt and many were refusing to service her any longer until her payments were made. That explained why she kept moving from doctor to doctor. Her general practitioner wouldn't see her anymore because she owed so much on missed appointment fees. There went the only hope of one doctor regulating all her meds.

After he got through the mail, he systematically pulled the prescriptions from his bag. He wrote down the name of the drug and each doctor, then each condition that had a medication for it on the white board.

_Hypothyroidism, Rhinitis, Vestibular Balance, Back Pain, High Blood Pressure, Arthritis, Insomnia, Depression, Severe Headaches, Overactive Bladder, Indigestion, Anxiety, Eye Irritation, Osteoporosis, ADD, Poor Circulation, Diverticulitis._

Next Chase went through all the over the counter medicines she accumulated. The most common were boxes and boxes of decongestants and antihistamines of many varieties and plenty of bottles of all types of cough medicine. There was also plenty of ibuprofen, acetaminophen, aspirin, calcium tablets, ear drops, eye drops, and creams for joint pain. Everything was in mass quantity.

_Strange, all this and no vicodin,_ thought Chase.

Cameron's jaw dropped at the list of problems when she entered the conference room. "These are just the problems there were prescriptions for," Chase told her. "We don't know what else could have been wrong at some point or is wrong now."

Cameron looked at the boxes of the prescriptions, over the counter medicines and supplements. "She has to be experiencing drug induced liver failure," said Cameron.

"One sign of that is loss of appetite," replied Chase. "Judging by her size and what her son said that is likely not the case. We should check for it anyway, just because it makes sense. It darn well should be happening. None of this can explain the loss of consciousness though."

Foreman walked in and proceeded to look at the board as well. "Mycotoxoisis? She was diagnosed with that?" he asked.

"That's my diagnosis," said Chase. "I found toxic mold in significant amounts in her apartment. It was all covered up by junk so she couldn't see it, and if she was congested a lot she likely couldn't smell it. That would explain why her lungs are struggling."

"It only explains the lungs though," replied Foreman.

"Here is a fact that might interest you. Her son said she had a bad head injury as a teenager," Chase added.

"I'll schedule an MRI," replied Foreman. "An old head injury could explain the later development of some of her problems."

"Yeah, some of them," replied Chase.

"She certainly is taking a lot of allergy medication. Any known allergies? Rhinitis is a big clue. She could be having a severe allergic reaction to one of these drugs." said Cameron.

"I'm going to be requesting medical records all afternoon," replied Chase. "I have a list to work with now including an allergist. Of course I also have to make a call to the Board of Health."

Cameron and Foreman looked at him with complete amazement.

"What?" asked Chase, confused by the reaction.

"You, call a state agency?" said Foreman with a goofy smile. "Has that ever happened before?"

"Be careful Chase, people who work in those agencies don't like foreigners. They hate it when you don't speak English." said a joking Cameron.

Chase wasn't in the mood for their harassment and ignored the remarks. "We can meet up again later once I have more info. Cameron, you run the liver test, and Foreman, you get the MRI."

Both paused reluctantly at the instructions. They were used to getting a rapid fire list of things to do with House along with more crazy theories.

Chase looked at them still standing there and said, "Please?" They both nodded and went off.


	3. Chapter 3

Wilson had to see if it was true. What sort of bat shit crazy individual would actually use valuable time off in order to torment a junior attending? Time that would normally take him away from a place that causes utter discontent. Even House couldn't be that crazy.

_Yep, he is._ Wilson's disappointment was realized when indeed he saw House there, completely relaxing in his office watching TV. This was no different than any other day at work by the looks of it.

"I was going to call, see how your flight went. Somehow your brilliant mind has come up with a way for you to be two places at once." Wilson said in his usual lecturing tone.

"The weather here is great. I was going to have one of those umbrella drinks in your honor. Then I thought, no, this vacation should be about me." House replied in retaliation.

"Apparently. Remember when we had that discussion a way back about you needing to find a better outlet? You have got to learn to be better at something else. Now your behavior can be considered pathological. Since you are in Cancun, I would recommend cliff-diving. There is a thrill seeker with potential for catastrophe, which isn't much different from what you are doing now."

"I actually took a vacation, didn't I? You have to admit that is a breakthrough."

"Using your personal time to cause tremendous grief for someone who has so far proven to be a worthwhile employee is not something they like to bring up in management sensitivity training," observed Wilson.

"You're just jealous that you have to stay behind and work. Come on, admit it, you want to go too."

"No, I'm going to do something better. I'm going to do something that will so drive you nuts and all you can do is sit there and watch. I'm going to give encouragement, support, and advice to your new attending on his first case since you aren't here to do so."

"You wouldn't." House said as he popped up taking the threat seriously. "What the hell am I saying, of course you would. Does your outfit come complete with tights and a cape? Superhero nice doctor swoops in and saves the day. Stay away. I don't meddle with your staff."

"Actually, you do all the time," countered Wilson.

"You and I never agree when it comes to the children. They need tough love. The boy has to learn these things himself."

"Pardon me, I didn't hear that. You aren't here."

"You're spoiling them. No wonder they like you best." said House as Wilson walked away.

Wilson left the office smiling because for once he was leaving with the upper hand. He had to savor this moment intensely.

-------------------------------------------

Chase was busy in the conference room processing all the records that he received for Estelle. Only a few doctors still owed him records, but he knew enough to really get started. He had trouble understanding how all these doctors would just look at the one particular problem and not look at the entire picture. To just write a prescription for one ailment was a mentality that was so lost on him as a fellow doctor. Sure, he was guilty at times of just writing a prescription without knowing all the facts, all doctors were. How could Estelle get so many doctors though to act like that? Given the state of her apartment, she likely didn't have any friends or anyone who was willing to check on her. She probably annoyed anyone who came in contact with her, which meant her doctors wanted her out quickly. That was no excuse, but a very likely scenario. He had seen it way too often.

While lost in that train of thought, Chase received a page. He looked at the message and raced up to the ICU.

Chase arrived a few minutes later to find Cameron standing in the background while the crash team worked on his patient. "What do we have?" Chase asked jumping into the middle of the action.

"Cardic arrest," said the trauma doctor on duty. They had already started using the paddles and had been working for several minutes. "Epinephrine now!" shouted the doctor.

Just as she uttered those words, Estelle's heart went back into normal sinus rhythm. "Hold off on the epi or anything else," ordered Chase. "She has hypothyroidism and hypertension. Who knows what any type of stimulant will do to her already fragile state. Let's see if she stabilizes on her own."

Chase walked over to Cameron to see what happened.

"Chase, we have to give her some type of stimulant," said Cameron. "Otherwise she will have another attack or even worse."

"If we do anything we might get the same result. She is a train wreck. We need to know more about what is going on." Chase then realized what he was doing. He knew it was never a good idea to disagree with a colleague in front of a patient, even if the patient was unconscious. He stopped himself there and led Cameron out into the hall.

"What happened?" Chase asked Cameron now that they had a bit more privacy.

"I just got a liver sample to perform the test. Next thing I know she was crashing."

"Did you get the sample?"

"Yes," replied Cameron.

"Go perform the test. If her liver isn't failing due to the drugs then we can administer something to stabilize her. Until we know all the facts, she gets nothing. Her system likely doesn't want us bothering it right now."

Cameron nodded and went to the lab to perform her test.

Chase stood in the hallway alone, staring through the glass while the nurses finished up with Estelle. He didn't know if he was doing the right thing, but he surely was convinced it wasn't wrong either. Still, House would be having a fit over such a cautious strategy. Too bad, he thought, at least the patient is still alive.

"There you are," said Foreman. "I have been looking all over for you. Is she stable?"

Chase nodded with a bit of a frazzled look on his face.

"The best I could get was an MRI tomorrow morning," said Foreman

"We need one now," said Chase. "Did you tell them that was unacceptable? Our patient is a time bomb here."

"They are backed up and didn't see her case as urgent as the others. They don't get very sympathetic to drug users when there are other priorities." replied Foreman.

"You left it at that? Especially since her drug use is legal?"

"No. I told them that my attending would be contacting them." He gave a smile and patted Chase on the back. "Good luck with that."

Chase couldn't believe what he was going through just to deliver basic medical care to a patient. No wonder House has resorted to treachery. It was the only way to get anything done.

-----------------------------------

Chase took the long walk upstairs to the MRI desk. He knew the person responsible for the scheduling well. His name was Brian, and he never did like him very much. He was such a weasel. Chase knew he had suck it up though and play nice.

"Brian, please, I need to get a patient in for an MRI stat," Chase said to this young man as he worked on paperwork behind the main service station.

"I have some time tomorrow morning."

"Dr. Foreman already scheduled her then. I need her in now. She just coded in the ICU and we can't figure out what is wrong with her."

"Oh, so you're the attending he was sending to give me hell?" Brian paused to laugh. "Geez, how anticlimatic. I was expecting Dr. House. I had a good argument planned."

"House is on vacation. My patient needs to get in now."

"No such chance. We are all full. Tomorrow is looking good."

"Come on, we are both reasonable people..." Chase said trying a smooth approach.

"Sorry, the kindness act doesn't work on me," he interrupted. "Tomorrow."

Chase paused for a moment and then got an idea. He hated using a House tactic, but he was desperate. "Brian, I know all about the smoking weed with the orderlies on break. Should I have a talk with your supervisor?"

The young man laughed harder this time. "You won't say anything. You aren't that devious. Even if you are, go ahead. I dare you to prove it."

"A patient is dying and you don't care?" said Chase who was trying desperately to find the right tactic to work.

"Look Dr. Chase, I have put up with all of House's tricks for way too long. It's about time his department took its proper place in line. Everyone is dying today. Take a number."

Chase had nothing else to use. "Your boss will be hearing from me." Brian looked less than intimidated. Chase gave up and went back to regroup.

-------------------

"She is in great strife and we don't know what is wrong with her." Chase said pleading to the person on the other end of the phone.

"She wasn't abusing prescription drugs, she was following her doctors orders…"

"Yes, I know no reasonable person would take prescriptions from that many doctors, but she isn't reasonable…"

"So just because she's a little mentally ill that doesn't give her the right to a quick MRI that might save her life?..."

"If she dies in the middle of the night you are the first person to testify at the review." Chase slammed down the phone.

"Great," said Foreman. "Pissing off the MRI supervisor is not going to earn you any future favors."

"It never hurt House," said Chase. "Then again, I'm not that evil."

"So, you are just going to give in and wait until tomorrow morning?" Foreman asked.

"It's already late in the day. She just needs to stay stable for an evening." Chase said resigned by the fact that he lost this battle.

Then Cameron appeared in the doorway. "I have the results. She has acute liver damage from the overload of drugs, but not enough yet to cause failure or other significant problems. You should see this though." She handed Chase the sheet of paper showing the results.

"Cancer?" he asked surprised by the result. There were none of the typical signs of liver cancer.

"Maybe. There are some abnormalities that make it possible. Dr. Wilson is around and waiting to hear from you for a consult."

"Great, maybe he knows secrets as to how to get an MRI too," replied a very cynical and tired Chase. "You two can go home. There is nothing more to do this evening." Then he turned to the office. "That goes for you too, House!"

Chase grabbed the file and dragged himself off to yet another area of the hospital to talk to yet another source about his troublesome patient. Cancun did sound rather appealing right now.

---------------------------------

"Dr. Chase I presume," said Wilson as Chase entered his office. "You are looking a bit haggard. Case not going well?"

"What House hasn't told you about every moment? I'm giving him enough material to taunt me for the next hundred cases."

"I refuse to talk to him while he is on vacation. He needs his quality "me" time." replied Wilson. "Do you think you are actually doing anything wrong?"

"No, I'll admit to being cautious, but this is no normal case."

"I have heard that. So what do you have for me?" Wilson asked easily wanting to get House out of the conversation.

Chase handed him the incredibly thick file that seemed daunting for a case that was only presented earlier today. Wilson opened it and Chase enjoyed watching his eyes jump out of his head just like his own had earlier in the day.

"You need more than a consult," Wilson said as he flipped through the pages. "You need some sort of divinity here. You could call her a miracle patient because she is still alive."

Chase smiled at the comment, probably the first time he has smiled all day. "Yeah, I'm sure I could convince the Catholic Church easily to declare this a miracle. It would be a slam dunk."

"Cameron's test definitely hints that something is there. If it is in her liver, she likely has similar problems in other organs. You have the MRI results?" asked Wilson.

"That is a bit of a sore subject right now," replied Chase as he got a quick look of aggravation. "I'll have something for you tomorrow morning."

"Chase, I know you aren't one to ask for advice, but do you mind taking some this one time? You know, from one attending to another." Wilson said sincerely.

"Sure," replied Chase.

"The respect will come from others, but it will take a lot of time. When it comes to your fellow doctors, House is the only one that respects you. He has very strange ways of showing it, but you wouldn't be in this position if he didn't. The point is, once people see you as something other than House's yes man, it will get easier."

"Did you have the same problem when you became an attending?"

"You don't want to hear about my ordeal," said Wilson with a big smile. "I'll scare you too much. I made mistakes, but it turned out that was okay."

"Thanks Dr. Wilson," said Chase with an appreciative smile.

"Just relax and go with your instinct. It really is that easy." Wilson replied. "And I need that MRI no later than tomorrow morning."

"Yes sir," Chase said as he left the office. He was ready to go home and crash now.


	4. Chapter 4

Before Chase could even walk through the front door of the hospital the next morning his pager went off. The message was from Foreman and simply read, "No MRI." That was enough to get Chase to race up the stairs rather than waiting for the elevator.

"What happened now?" Chase asked Foreman as he arrived at the conference room.

"They bumped us. It seems a few critical cases came in last night." replied a rather annoyed Foreman. He was not having a good morning.

"Until when?" asked Chase.

"Maybe this afternoon," said Foreman. "We can't wait that long."

"No, you think so?" asked Chase very sarcastically. "It isn't just your brain scan anymore. After talking with Wilson I need to get a whole body scan. He guesses that there could be tumors in multiple organs."

"So, if it is so damned important, then why are you standing here talking to me?" Foreman said turning confrontational. "You need to fix this."

"That is the one thing that has always annoyed me about you with House, stating the freaking obvious. I'm not stupid you know." Chase said fighting back.

Just then Cameron walked in. "You two should take it outside settle this like real men. In the meantime, I'll stay here and work on trying to making the patient better."

Chase and Foreman stood there for a minute, both trying to get hold of their tempers.

"Great, let's say we try a differential diagnosis," suggested Cameron.

"How about both of you work on that. Maybe I can actually get some help on this case for once. I've got other duties to perform." Chase stormed out of the office leaving Cameron and Foreman dumbfounded by what they just saw. They had never seen Chase lose his temper like that. They were not sure whether to be pleased or freaked out.

"Awwwkwarrrd..." said a high pitched voice coming from the other room.

"Shut up House," replied an irritated Cameron.

-----------

Chase knew it was time for drastic measures. He wasn't sure what he was going to do, but he had enough. He went to the ICU. "Natalie," he said to a nurse on duty. "I need you to help me take my patient for an MRI."

"I didn't see where she was scheduled for one on the chart," she replied.

"Yes, she's scheduled, or she will be. Can you help?"

"Yes Dr. Chase," she replied.

Together they moved Estelle and all her equipment and transported her downstairs.

"Put her right here," he instructed Natalie. He had her put Estelle in front of the entrance to the MRI scanning area thus blocking its access.

Brian came right over. "This isn't going to work Dr. Chase."

"I'm going in now," he adamantly replied.

Brian was not at all accepting the statement. "At this rate I'm not sure I should to let you in at all. Move the patient from the door or I'll find a bunch of big guys that will. They will snap you like a twig."

Just then the MRI supervisor came out after hearing the commotion. "We have more critical needs right now Dr. Chase. You need to wait."

"She has been in the ICU since early yesterday patiently waiting her turn. She has waited long enough." Chase argued.

"I'm calling security," said Brian and he retreated to the desk.

That was Chase's breaking point. Near him was a table with medical literature and a glass vase with flowers. He stepped over to it and in one fluid movement swept the table's entire contents onto the floor. The noise of the shatter startled everyone within earshot.

"What do I have to do to get basic medical care for a very ill patient around here?" Chase shouted very loudly.

The MRI supervisor stood in her tracks stunned by the display. "Brian," she said calmly, "Let him in." Then she told Chase, "Make it quick."

"Thank you," Chase replied as he got control of himself. He and Natalie took Estelle inside.

"Brian, go help him. That woman is over 300 lbs." said the supervisor.

"You are going to give into these stunts?" Brian asked.

"I have worked with Dr. Chase for over two years and never once has he lost his temper. This might be the nutty we have all been waiting for." she replied.

Brian nodded and went into help.

Cameron and Foreman were in the conference room when the phone rang. Cameron saw it was coming from the MRI desk. "Hi Natalie," she said as she answered the phone.

"He did what? Yes, I'll be right up to help." Cameron slowly put down the receiver in stunned silence.

"What is it?" asked a concerned Foreman.

"Chase just had a fit up at the MRI desk. Apparently he completely lost it and damaged some things. They just let him in with his patient. I need to go help him." Cameron explained.

"I'm coming too," said Foreman.

House sat in his office with a bittersweet smile. He had waited for so long for Chase to finally act out, but he was sad that he wasn't the one who provoked it.

------------------------

The three ducklings all got back from the MRI knowing they had several abnormalities to analyze. One thing for certain was that Dr. Wilson really needed to be involved now.

"Did you page Wilson?" asked Foreman as they all grabbed coffee to prepare for what they knew would be a long session.

"Yes, he's on his way," said Chase. "Before we get started, I want to apologize for losing my temper."

Cameron and Foreman glanced at each other and then looked down while slightly giggling.

"What's so funny?" Chase asked.

"We actually have been waiting for a long time for you to do that. You know, grow a backbone." said Cameron. "Nobody should take as much provoking as you do and hold in all so much anger for that long. It just wasn't human. We were kind of relieved."

Chase couldn't argue with that analysis. He had to admit, it felt pretty good afterward. "Okay then, let's go through this." he said getting back to business.

Chase walked over to the whiteboard and noticed something wasn't right. All the symptoms had been erased and rewritten backwards. Cameron and Foreman busted out laughing at Chase's annoyed reaction.

"Forget the patient troubles," said Wilson noticing the board as he walked in, "It looks like the doctor isn't quite right either. Writing backwards is a disturbing condition. Care to talk about it?"

"It seems we have a practical joker among us," said Chase loud enough so he could be heard from the other room. He walked over to the drawers, pulled out a hand mirror, and then held the mirror up to the board each time he wanted to read a symptom. "Who wants to start?"

"The brain scan gave us a good history, but nothing conclusive." started Foreman. "You can see the old head injury impaired her in certain ways. She has small lesions surrounding the area of impact. I can see why she has a diminished ability to reason, coordination and short-term memory issues. The lesions aren't the main source of her headaches though. That comes from her neck where she must have suffered other injuries."

Foreman got up and walked over to the MRI image on the light board. "You can see a small blockage here." Foreman pointed to a spot on the image. "She is a huge risk for a stroke if we don't fix that."

"She's not stable enough to fix it now, but we will observe it," replied Chase. He noticed Dr. Wilson over at the light board as well intently studying the results. "See anything?"

"You mean aside from the masses and cysts that exist in just about every major organ? Except for the lungs. You were right about mycotoxosis. I suspect that the cysts are all caused by mixing the wrong supplements, but I need to check them out for sure."

"The liver sample we got drove her into cardiac arrest" said Chase. "She isn't tolerant to procedures right now."

"I'm a highly skilled oncologist," said Wilson with a smile. "I know ways of getting samples that aren't as invasive. Of course I'm going to need a good Intensivist to be there to take action if something does happen."

"Trust me, that is a role I can easily jump into," replied Chase. "It would be nice to go back to hands on medicine for a bit. What about her liver?"

"We need another sample, but it isn't looking as bad as it could. I don't see anything different there than the other organs."

Cameron was silently analyzing the MRI results while the others were talking.

"She needs an antibiotic for her lungs. The irritation in the right lower section is pronounced."

"She can't get anything until her body is clean," replied Chase. "She is running a mild fever but that hasn't gone up since she was admitted. She can wait for now."

"You aren't going to allow anything?" asked Foreman. "She is at risk for infection."

"Her body currently is at civil war. When all those medicines got mixed together, they started to work against each other. We can't possibly predict what yet another drug will do, but it won't do her any good." answered Chase.

Cameron and Foreman gave Chase a skeptical glare, but didn't have convincing arguments to fall back on. "Okay," said Cameron, "while you and Dr. Wilson are busy I'm researching drug interactions in the lab."

"I'll join you," said Foreman to Cameron.

"Great, we have a plan," said Chase, glad too see that Cameron and Foreman were willing to work that hard to prove him wrong. That is the most respect they have shown him throughout the entire case thus far.


	5. Chapter 5

"Damn," Cameron said as she looked at the latest results through the microscope. "The more I add, the more unstable the reaction. No wonder she was in so much pain. All these prescriptions were working against each other."

"There has to be something that will work. We have to keep trying." replied Foreman.

"How much time do we have? This could take weeks. By that time all the drugs will be out of her system or she will be dead."

Cameron decided to take a small break from the microscope. She and Foreman had been running tests for a few hours and she was getting a bit loopy. She leaned back in her chair and had a long stretch while yawning from mild exhaustion. Foreman noticed her break and decided it was time to stop looking at samples as well.

"Foreman, do you think Chase is doing a good job with his first case?" asked Cameron, ready for a diversion from the tedious lab work.

"Better than I thought he would," replied Foreman.

"How did you think he would do?"

"He has always seemed lazy to me. He has really jumped in and worked hard to get things done. I never knew he had it in him."

"You never know how people will react when they are thrown outside their comfort zone," answered Cameron. "Personally, I'm having trouble taking instructions from him. No, I'm just having trouble with him in that role in general. It doesn't seem natural."

"That's because you aren't in awe of him like you are House," replied Foreman with a slight laugh. "That and you know him in a different way. I'm sure it is strange."

Cameron was silent in her response because she couldn't argue with his observation.

"Chase is doing his job," continued Foreman. "You have give him that. I still don't trust him, but I don't trust House either. It is my job to keep both of them honest."

"I'm just not sure if I want to be put in that position either," said Cameron. "It gives me a lot to think about over the next few months."

Cameron tried to continue but realized she couldn't. She sighed then got up to leave. "Where are you going?" asked Foreman.

"To get more blood from the patient. With this many tests we will end up bleeding her dry."

------------------

Cameron arrived at the ICU to see Estelle alone. The absence of Wilson and Chase indicated to her they were done with their procedures. _She looks like an oversized pincushion,_ Cameron thought as she noticed all the areas that were poked and prodded.

Cameron stood next to the patient and started to open the sealed tube for the blood sample. As she fumbled with the package it ripped open and fell from her fingers onto the floor. She bent over with anger at her clumsiness to pick it up and then abruptly stopped as she noticed something behind Estelle's left ear. She examined the mark intensely, then whipped out her pager.

"What's up?" Chase asked Cameron a few minutes later as he arrived. He was still in scrubs from his work with Wilson.

"Look at this," said Cameron. She pointed behind the left ear.

Chase reacted with deep surprise uncertain as to how they missed that previously. It was well hidden behind the ear though. He took his turn to intensely study the mark. "Insect bite?"

"It looks like it, very likely a bee sting." Cameron replied.

Chase walked to the end of the bed and opened the chart. "Her previous allergy test showed her negative for bee stings."

"She had been taking bee pollen though," said Cameron. "One insect bite wouldn't push her over the edge, but couple that with the supplement and you have a harsh reaction."

"Anaphylactic shock doesn't fit here." Chase said quickly jumping in. "Her blood pressure is very high, not very low. It explains the unconsciousness though. Page Foreman and we'll discuss this in the office now.

-------------------

Chase arrived at the conference room and grabbed the eraser intending to wipe the white board clean. He stopped before doing so though to examine the new artwork decorating it. There was game of hangman that spelled out "Aussie". At the end of the noose was a picture of a kangaroo in a lab coat.

"Hangman is supposed to have seven letters," Chase shouted to House in the other room.

"Aw, come on Chase," said Cameron smiling, "he's cute."

Chase flashed her a "get real" look and proceeded to erase the picture.

"We are starting from scratch," replied Chase. "We have been looking at the problem all wrong. We shouldn't analyze her symptoms. We need to analyze the starting point and then the chain reaction afterward. Let's start with what is likely the trigger."

Chase wrote bee sting on the board.

"I'm assuming you ruled out anaphylaxis since it hadn't been mentioned yet," said Foreman.

"It can't be. Yes, she has respiratory distress and loss of consciousness, but no hypotension and since she wasn't treated for a severe allergic reaction she didn't experience the usual death either.

Chase then wrote _loss of consciousness,_ _malignant hypertension,_ _low heart rate _and _respiratory distress _on the board.

"Respiratory distress was caused in part by the mycotoxosis." said Cameron.

"I think we can assume before the bee sting she had many things wrong with her. We need to look at the reaction. What are causes for malignant hypertension and low heart rate."

"Sleep apnea, obesity, sedentary lifestyle, combine all that with an allergic reaction and who knows?" said Cameron. "She was on an ACE Inhibitor for the blood pressure by one doctor, and then taking NSAIDS for arthritis and she was taking ibuprofen on her own. That rendered any benefits of a drug controlling her blood pressure useless."

"Wait a second." Chase said as bells started ringing in his head, "Arthritis. If the ACE Inhibitor wasn't working, the NSAID wasn't either." Chase said. He then wrote on the board _pain. _

"Care to be more specific?" asked Cameron.

"No, he's onto something here," said Foreman."The autonomic nervous system's response to pain receptors plays a role in physical reactions."

"It's not just that. She was supposed to see a Rheumatologist next week about possible Fibromyalgia." said Chase.

Foreman saw where he was going with this and started working out the analysis. "Okay, let's assume she has Fibromyalgia. The causes are not clear, but one possible cause is chemical changes in the brain which affects the regulation of neurotransmitters. That would cause her migraines and depression, but it would also increase her amount of pain."

"Isn't one of the possible causes also a viral infection?" asked Cameron?

"That isn't well proven and not a common cause," replied Chase. "None of her problems hint of anything viral. There is however one possible cause that fits the best here." Chase wrote on the board. _Abnormal reactions of the SNS_

"Fight or flight," said Foreman.

"Exactly," replied Chase. "A normal sympathetic nervous system reacts to stress properly by releasing epinephrine and norepinephrine to the adrenal glands."

"So the adrenal glands didn't properly regulate the heart rate and constrict blood vessels during a bee sting and that threw her entire body into complete distress," said Foreman

"It allowed too much epinephrine to enter her system. That caused an adverse reaction to her already the high blood pressure, thus sending it through the roof." Chase added.

"What about the low heart rate?" asked Foreman. "If she had too much epinephrine in her system, that would have gone up too."

"That has since stabilized. A common cause of low heart rate is improper medication. She was on blood thinners."

They all took a moment to process this new line of thinking. To Cameron, it was a bit far-fetched. "Many of the same symptoms could be caused by her hypothyroid medication not working. There could be nothing wrong with her sympathetic nervous system. If that is the case, she needs more epinephrine."

"Her heart is too weak," said Chase. "The cardiac irritation caused by the epi would be too much for her. What she had in her system already caused damage."

Cameron and Foreman took a moment to objectively process this theory and analyze other options.

"How about ibogaine?" asked Foreman. "It's experimental, but it is proving to be effective for rapid detox. We need to get the drugs out of her system faster so we can do the proper treatment."

"Ibogaine causes fatal cardiac arrhythmia," replied Chase.

"In isolated cases," said Foreman.

"Yes, those cases being someone with a bad heart and bad health in general."

"It might be worth the risk," said Foreman.

"She likely die if we try anything drastic," said Chase. "All she needs right now is more time for the IV fluids to run through her system."

"So the strategy right now is to do nothing?" exclaimed Cameron. "You'll end up killing her."

"I'll entertain more ideas. Until then, yes, we do nothing. Even House will tell you no matter what, sometimes patients die. We shouldn't be the ones that end up killing her because we want to be heroes."

"Okay then," said Cameron not ready to give up the fight. "Back to the lab. I'll see if I can't find that better idea."

Foreman looked at Chase. "I'll start looking into other rapid detox procedures."

Chase watched as they left and then he took a deep breath of relief. Now was not the time to be uncertain, so he had to hold his ground. He was being judged. Then he went to the white board and started drawing his own hangman picture.

----------------------

Cameron waited around until Chase went up to the ICU. When he did she pounced on the opportunity.

"House, you've had your fun. Now get in there and stop this madness." Cameron said as she flung her way into House's office.

"My tickets are non-refundable and non-changeable. Coming back early won't be possible."

"Chase is in over his head. He isn't making good choices. Come on, you have heard everything. His plan is wrong. His patient will be dead soon if we don't do anything."

"You act if though you have a test that proves you are right. I believe there was a suggestion of coming up with something better?"

"Come on, his theory is even crazy for you. We need you to step in and use your legendary brilliant mind. A patient is dying here."

"Flattery is so beneath you. I'm disappointed," replied House. "Patients are always dying. They can die while I'm enjoying my vacation in a tropical paradise. I'll still sleep at night. Now go away. I'm having a drink soon at the cabana with Swedish twins."

Cameron turned to leave in disgust. She knew she didn't have much time to do this and House wasn't changing his mind.

"Read some of the articles by Rowan Chase. He was one of the first Rheumatology experts to acknowledge Fibromyalgia as a disease. He knew what he was talking about." House said as she was leaving.

--------------------------


	6. Chapter 6

Chase stood alone in the conference room, lab coat off showing the nutmeg brown dress shirt and pale yellow tie that were mostly hidden previously in the day. His arms were folded and he posed like a statue staring at the words on the white board. The day was winding down and he still had yet to find a way to help his patient. All he was able to do so far was deeply understand her predicament.

Wilson walked in to see Chase posed at the board the same way he has witnessed House so many times. He wasn't sure to be happy or scared by this moment. Speaking of House, he looked over and noticed he had gone for the day. _ Damn I was hoping to get a beer_, he thought.

"Chase," Wilson said, "I've got back all the biopsy results. All the tumors are benign."

"That's good to know," replied Chase. "I don't think I can add anymore issues into the scenario."

"She's going to need surgery on her kidneys and liver to remove large tumors when she is stable, but for now they aren't hurting anything."

Chase quietly nodded while continuing to stare at the board in deep pensive thought.

"Sympathetic nervous system stress?" said a surprised Wilson as he read the board. "I suppose that is possible, but good luck proving it."

"Yeah, tell me about it," said a very tired and stressed Chase.

"Look," said Wilson noticing Chase's frazzled demeanor, "come with me. We both really need a beer."

Chase was thrown back by the invite. He and Dr. Wilson never talked much professionally, let alone in a social environment. "Okay", he said pleasantly surprised, "I'm up for that."

------------

"Why an Intensivist?" Wilson asked Chase as they got another round of beers. "I think the burnout rate for Intensivists is higher than Oncologists."

"I'm good at making people comfortable," Chase replied. "It fit."

"Adrenalin junkies become Intensivists, not people pleasers," Wilson countered. "Couple that with a long fellowship under House, well you must be certifiably crazy."

"I like the pace," Chase admitted, "but when I first got into medicine I would have been happy being a country doctor too. Opportunities pushed me otherwise."

"I can relate to that. I ended up learning Oncology because my uncle had cancer. One taste of the frenetic pace and I was hooked. Why the US though? Why go 8,000 miles from home?"

"Medicine in Australia wasn't as challenging. For one, I was in the shadow of my father. I didn't want to be the high profile doctor he was. I just wanted to heal people. Then, my entire internship was with a nice older outback doctor that was very set in his old-fashioned ways. He didn't want to open his mind or learn anything new. It ended up bring very dull because I liked to see all possibilities. It drove him crazy."

"But House?" asked Wilson. "Isn't that a little extreme?"

"When I had the opportunity to learn in a new country where the name Chase wasn't well renowned in medicine under an ill mannered but brilliant doctor, well I just couldn't refuse. Crazy, absolutely, but I was at a point where I was tired of playing it safe."

"Safe you did not, that is for sure. I have known House for almost fifteen years and I still don't feel safe around him. I'm always wondering what he will do next. So, have you gotten everything you wanted out of this?"

"I certainly would have never put Diagnostic Attending on my career aspirations list. Of course, I didn't have a career aspiration list. I just wanted to be a better doctor." Chase replied candidly.

Wilson sat there smiling at what Chase was saying. "You are surprising me."

"How so?" asked Chase.

"I have seen you work with Foreman and Cameron a long time. They are always bending your ears about something personal. House said you never once have told them anything about yourself or brought your issues to them. I'm surprised you are talking so easily about yourself with me." Wilson said.

"I talk about myself all the time to patients. That personal connection makes treatment much easier for both of us. I'm selective though. That approach only works for certain people. Cameron and Foreman are not those people."

"I'm House's best friend and I can't easily talk with him. He never wants to know about my life unless it involves torment and harassment." Wilson said. "I know what you mean though. Patients are often easier to relate to than your own co-workers."

Just then Chase's pager went off. He pulled it off his waist and read that he needed to check in with the ICU. "It looks like I have to go back," said Chase. "Thanks Dr. Wilson, I really needed that break."

Wilson smiled as Chase left. _What a good kid_,he thought. He wondered how it was that he and Chase never talked much before now. No wonder House has always liked him.

----------------

"Her heart is getting weaker," said the ICU nurse as Chase checked in on the status. "Her blood pressure is still not dropping."

"Okay, let's start her on a diuretic. Start her on 125 mg acetazolamide. We will have to watch her kidneys though because it will be harsh on them. Let me know if anything changes. I'll be back first thing in the morning."

Chase got in the next morning and proceeded directly to the ICU. The results were not good as he suspected. The diuretic was wreaking havoc on Estelle's kidneys, which was causing her body more stress, so the blood pressure wasn't going down. He had them cut the dosage to see if that would help. Then he went to inform Cameron and Foreman of the situation. He was already feeling a bit agitated, so he knew he better watch himself around Foreman.

"We should try an anti-diuretic," said Foreman. "Vasopressin is used for lowering blood pressure. It is also used when patients don't respond well to high amounts of epinephrine."

"Vasopressin can cause intense allergic reactions in hypersensitive people. Given her reaction to the bee sting, I would put her in that category." Chase countered.

"There is a risk of that happening," argued Foreman, "but the benefit could outweigh the risk."

"The last reaction almost killed her. The next one will." Chase replied.

"She's is going into heart failure. She needs some type of drug intervention now." Foreman was starting to use his demanding tone. 

"Drug therapy at this point will only kill her faster," Chase argued back. "She still has too much in her system and it is making her worse. We need to focus on detox methods or SNS therapies that are not stressful to the body."

"There is no time for that now!" shouted Foreman. "She needs immediate action."

"No action is buying us time right now!" Chase shouted back. He could really feel the anger well up inside. Then he paused and decided to try a calmer tone. "Anything else will just quicken the end and that will do us no good."

"If something doesn't work, you try something else. Doing nothing will not fix the problem." Foreman said in very aggressive manner. He was not ready to back down. "We should try an ibogaine rapid detox now so we can treat the real problems."

"You know her heart and kidneys are too weak to handle such a process, and her lungs aren't looking so hot either. Any solution cannot involve more stress to an overly taxed system." Chase said trying to be professional, but the edge in his voice hinted that he wanted to choke Foreman.

"You are being irresponsible. I'm going to Cuddy." Foreman declared in contempt.

Chase was furious at this point, but stood there with a scowl and his arms folded while maintaining composure. "Cameron, please leave the room."

"Chase I…."

"Now!" he said very firmly. Cameron stared at both Chase and Foreman with worry and left slowly while watching both of her colleagues. She wanted to be sure they weren't going to kill each other.

"Close the door behind you," Chase instructed. He then walked over to the door to House's office and closed it.

"I know you don't respect me," Chase started in a calm voice, "think you're a better doctor, and believe the only reason I'm in this position before you is because I got here a year earlier."

"I'm supposed to question..."

Chase interrupted and started talking firmer and louder. "Your arrogance and in-your-face challenges work great with House, but that doesn't work with me. When dealing with other doctors, you are going to have to know when you are being constructively arrogant and when you are being a complete jerk! Guess what you are being right now."

"You are wrong about this." Foreman said defiantly.

"Back off now! My decision stands."

Foreman and Chase stared at each other delivering a message with their eyes that neither was going to back down. "I'm the attending in charge," said Chase. "It's my call."

Foreman finally relented. "Fine, go ahead and kill your patient. You're the one that will have to answer to your actions." He stormed out of the office.

Chase continued to stand there, arms folded, seething over the argument. He opened the door to House's office. "I hope you enjoyed the show, House."

"This is the best vacation ever," House said shouting back.

------------------------------------

Cameron wasn't waiting anymore for Chase to gain control of the situation. Since Foreman was getting a talking to, she would have to see Cuddy on their behalf.

"Is her family complaining?" asked Cuddy as her hands rubbed her temples on each side.

"No, but..."

"Then we don't have a problem," said Cuddy. "It's not like Chase is giving her poison."

"He doesn't know what he is doing," argued Cameron. "He believes that waiting while doing nothing is all we can do."

Cuddy dropped her arms to the desk and positioned them so she could address Cameron in a more official tone. "When House told me he was promoting Chase, I knew that the adjustment for all of you would be rough. However, I like House truly believed Chase was ready for the challenge. So far, he has not proven either of us wrong. Since you are the only one complaining, and I'll likely see Foreman in here soon, I'm going to tell you both the same thing. Adjust."

"What if the patient dies?" asked Cameron.

"Then Chase will have to answer to me. He knows that though and he isn't in my office complaining about it." Cuddy firmly answered. "Anything else?"

Cameron shook her head, got up with her trademark pout and quietly left.

----------------------

Chase stood in the office alone, tired of looking at a white board that offered no answers. He started pacing around. Maybe movement will give him the idea that was eluding him.

He walked around the table and saw a stack of mail sitting there waiting to be read. _Sorting through some mail for a few minutes should help give my mind a break_, he thought. He shuffled through the stack and found that his monthly journal to alternative medicine had arrived. As he glanced at the cover, his eyes popped open real wide as the idea finally hit him like a huge ton of bricks. "Of course," he said slapping his forehead. "Why didn't I think of that sooner?"

He raced over to the phone. "Yes, this is Dr. Chase. I need Estelle Anderson moved to a private room immediately."

--------------------

Cameron and Foreman arrived at the ICU later to see Estelle was gone. "What happened?" asked Cameron to the nurse.

"Dr. Chase had her moved to a private room. Something about a sensitive procedure."

"Thanks," replied Cameron.

"What do you suppose he is up to?" she asked Foreman.

"I'm dying to see what he has come up with," he replied.

They both raced upstairs to see what Chase was doing. They got to the room to find the blinds closed. When they went in, Chase and a young woman they never met before were working on Estelle. She was turned on her stomach and on her entire back were thin needles.

"Acupuncture?" said a very surprised Cameron. "Is that even allowed here?"

"Why do you think we are in a private room? I didn't want to raise any eyebrows." Chase replied.

Cameron and Foreman continued to look at him skeptically. "Come on, it fits," Chase contended. "A proven drug free complementary therapy for conditions such as acute and chronic pain control, allergies, anxiety, fright, panic…"

"Drug detoxification," said Foreman smiling. "I'll admit you are dead on. I'm mad I didn't think of it."

"This won't be a replacement, but it will help until she is better and her system is clean," replied Chase.

Cameron walked over to the monitors. "I'll be damned. It is already helping. Look, her blood pressure is slowly improving." She couldn't believe that Chase worked through the problem under all that stress. She never thought he had it in him.


	7. Chapter 7

"Mrs. Anderson?"

Estelle slowly fluttered her eyes open and focused on the face that accompanied the voice. "I must be dead," she said weakly.

"Why do you think so?" asked Chase who was focused on checking the responsiveness of his patient.

"I have to be," she replied in a still drowsy voice. "I have never seen a doctor so beautiful. That must only happen in heaven."

Chase flashed her a flattered smile. "No, you aren't dead. How are you feeling?"

"Like crap. You?" she replied.

Chase laughed. For someone who has been lingering for a few days, a sense of humor was an encouraging sign. "I'm Dr. Chase. I have been looking after you since you got here three days ago."

"You mean I got someone to pay attention to me for that long?" she replied. "I can't get someone to give me three minutes, let alone three days."

"It was rough there for a while and you still have a ways to go, but you are way better than you were," said Chase. "Waking up is about the best sign we have gotten since you arrived."

"What have I got this time?" asked Estelle

"You reacted badly to a bee sting," replied Chase

"I remember getting stung. My back hurt so much though I paid no mind to it. That is strange since I'm not allergic to bees."

"You are when you take supplements like bee pollen. You shouldn't be taking any supplements at all without checking with your doctors first."

"I never knew," said a stunned Estelle. "My girlfriend swore by it, said it changed her life. The medicines don't work anyway. I'm still in pain all the time."

"We can discuss all your meds later, but as a right now you are off all of them. They were poisoning your body and have slightly damaged your liver."

Estelle looked at Chase with complete confusion. "I don't understand. The doctors said I had to have them otherwise I wouldn't get better. Doctors have to be smart enough to know what they are doing. They wouldn't lie."

Chase was surprised by the naivety of such an older woman. Maybe because she didn't have 'everybody lies' drilled into her mind on a daily basis. Now wasn't the time though to give a lesson in drug interaction. "Like I said, we will go through all your medicine options at another time. For now, you need to rest."

"Is there anything you can give me for the pain?" she asked.

"Your body can't handle much medicine right now. You are limited to a low dose of acetaminophen. Also, an acupuncturist will be along later."

"Acupuncture? What kind of a hospital is this?"

Chase smiled reassuringly. "One that will make you better."

----------------

The next day Chase arrived at the hospital a little early. He wanted to catch up on some notes and line up consultations for his case. Estelle still needed a lot of help and it seemed like he was going to have to talk to every doctor in the hospital by the time all her problems were addressed. First priority though was a psychological consult. He also wanted to avoid Cameron and Foreman. He wasn't in the mood for differing medical opinions so early and just wanted to get his work done.

As he entered the room Chase was surprised to see House there, pouring a fresh cup of coffee. "What, you only get up early while on vacation? You must be desperately tired, you made coffee." Chase said to House as walked over to get himself a cup. He knew he was at great risk for trying anything House made, but the curiosity factor made the risk worth it.

"No more vacation," House said. "The tropics get boring after a couple of days. All the beautiful women started to look the same. Once the guys started looking interesting, it was time to leave."

"So you would rather look at us? I suggest a real vacation next time. There is something really wrong with you." Chase replied.

"Wrong with me? I didn't almost kill my patient." House replied.

Chase knew this was coming eventually. "Okay, have at it. I'm ready to hear about what a screw up I am." He then braced himself for the usual scolding.

"I was wrong," said House. "Actually, idiot would be the better word for myself. Nah, that's kind of harsh. For over two years, I pushed you harder and was nastier to you than anybody because that is how I get people to react. You however, never once pushed back and did what you should. The harder I pushed, the harder you resisted and didn't stand up to the challenge."

Chase stood there expressionless waiting for the rest of it.

"I had it all wrong. All this time I should have pretended that I was teaching a dog to swim. All I had to do was throw you in the middle of the pool and see if you could crawl yourself out. I would have saved myself some trouble, but then again it wouldn't have been as fun." House gave a wicked smile with that last comment.

"Anyway," House continued, "talk about not knowing how to work your staff. I should be blasted for that mistake on my performance review. When left to your own devices, you finally became the doctor you should be. Your work was exceptional. It's about friggin time."

Chase was getting used to House's strange ways of complimenting by this time. He didn't show it, but he was honestly surprised by the admission of competency. "Would you have done the same thing?" asked Chase.

"No," said House with loud disapproval. "Your approach was way too safe for my tastes. I would have gone with Foreman's detox solution. However, this department should at least have one of its attendings playing it safe, and I know I'm not changing."

Chase stood there now completely speechless, not sure how to respond. This was the closest he would ever get to validation with House, so all he could do was silently enjoy the moment.

"Acupuncture is one of the most creative solutions I have seen yet," continued House. "How in the world did you come up with it?"

"I had it done once," replied Chase, "after straining my back playing football, er, soccer. I never once had to take any pain medication."

"In that case you should have come up with it sooner," scolded House

Chase acknowledged his slow thinking with a shameful nod.

"Pressure is off for today. Go care for your patient. I'll deal with Cameron, Foreman and all new business."

Chase gave House a slight smile of acknowledgement and quickly left to find another place to do his work. He didn't want to give House a chance to change his mind.

---------------------

House was actually looking forward to the latest summons by Cuddy. Sure it was earlier than he would have liked, but he knew how much she was pining for him while he was on vacation.

"So, you missed me, didn't you?" asked House as he entered Cuddy's office without the customary knocking on the door.

"Were you gone?" asked Cuddy. "Of course you were, because my life was actually easier and work got done. How about you take a whole week? I'll even grant a month."

"Face it, you can't live without me. Your job would get so dull. Such peace and complacency would be the end of you. Why don't you tell me what you want so I can get back to degrading my staff?" said House.

"I have done an internal review of Dr. Chase's case and his performance."

"Don't blame me, I was on vacation."

"While I was rather miffed at first that you would be so irresponsible as to leave an inexperienced attending to handle such complex circumstances on his own, in the end it turned out to be the brightest move you have ever made as a supervisor." Cuddy observed.

"I just have a way with people," House replied mockingly.

"Your move would have been more appreciated if you actually went on vacation. What sort of sick twisted person... Oh yeah, you. You aren't getting that time back by the way. Anyway, back to the original point. Chase has wildly exceeded all expectations with this case. Not only is the patient improving, his case notes, treatment approach, and dictation are thorough and up to date. All required paperwork is detailed and perfect. I'm not sure where he learned that skill from."

"Yeah, no kidding," replied House. "Some people you just can't teach proper disregard for procedure no matter how hard you try. It's a natural skill I guess."

"I could have gone without the tantrum in front of the MRI staff, but then again they can be such jerks at times so I don't blame him. Now that I know that diagnostics has two very reliable attendings to run cases, I'm going to start sending more work your way."

"You can't do that," replied House showing fake concern. "We don't want to overwhelm the new doctor. He might get mad and quit."

"You don't get to be as selective with cases anymore," continued Cuddy. "You as head of the department still get to pick which ones you want to assign to yourself, but now you can pass those so called 'boring' cases onto your other doctor. I'll know though if they are all handed to Chase. We have an opportunity here now to build a top-notch diagnostics department that everyone can use, just not your challenging puzzles. Besides, with Cameron's fellowship up in a few months, we might be able to use the increased case load to justify another attending."

House got a slightly solemn look on his face. "I'm not sure about Cameron. She might not be up to this challenge by then. She isn't now."

Cuddy was surprised. "I know putting down Chase all this time was an act for you to motivate him, but you honestly thought he would be a better attending than Cameron?"

"Come on," replied House, "you read her review. All that wasn't made up you know."

"I was considering the source," said Cuddy.

"Everything I said in those reviews was true, especially Cameron's. Until she can start making decisions with her head instead of her heart, she won't be ready to run cases."

"How about Foreman?" Cuddy asked.

"He's more than ready now, but I honestly don't think he wants to work for me once his time is up," replied House. "So what do you think about your plans to make this almighty diagnostics department now?"

"I'm still increasing your case load. We can go from there. There are other talented doctors out there if your team doesn't want to rise up."

"I hate doctors," replied House as he got up to leave. "They are all so arrogant and into themselves."

-----------------------------------

House spotted Wilson in the hall after leaving Cuddy's office. He pretended not to notice him.

"House," Wilson said as he ran toward House noticing the brush off. "You look like you're back from your vacation. Where's my tacky souvenir?"

"I'm not talking to you," House told Wilson.

"Was it something I said, or did you meet someone else? You didn't get friendly with the cabana boys did you?" asked Wilson mockingly.

"You had a beer with my doctor. That's betrayal."

Wilson flashed a 'is that all that's bothering you' expression. "No matter what you might believe, sometimes compassion is required in cases of human suffering," defended Wilson. "The kid looked like he just lost his puppy. How did you find out about it anyway?"

"I have spies. Did you two get a room?" asked House bordering on hurt.

"You have misled me this entire time," replied Wilson. "I'm the one that should be mad. Granted, I know you are often not truthful, but why didn't you tell me Chase was anything but a lazy spoiled rich kid? He has to be one of the most down to earth, level headed, intelligent people I have met in this profession. That is saying a lot."

"Chase isn't rich," said House

"How do you know that?"

"He told me."

"He told you," replied a disdainful Wilson. "Let me guess, he broke after enduring your intense badgering. A beer would have been much easier."

"Well, I'm happy for you both," House quipped back sharply. "What do you and your new best friend have planned next?"

"Sorry it seems offensive to you that two professional colleagues would take a moment to have a beer after a particularly crappy day. Oh wait, that happens with us all the time."

"You said you were just going to be nice and encouraging," ranted House. "A beer? That is taking a threat too far."

"He needed all the support he could get and wasn't getting any from anyone on your team," said Wilson now in his usual full lecturing mode. "You should be very proud in that you have succeeded in your quest when mentoring young doctors. They all are now brilliant in being completely hateful toward each other."

"This is the real world, not preschool. There is no playing nice. Besides, it finally got Chase to stand up didn't it?" House said defending his management logic.

"Even the most moral and sympathetic of your doctors decided to take a page from the House school of inhumanity. It was sickening to watch."

"Cameron is mean to Chase all the time," countered House. "This was nothing new. He took it like a man for once."

"Forgive me for being weak and actually showing some sympathy. You might want to try it sometime. It is called acting like a human being. It works wonders for the soul."

Wilson left House standing alone in the hallway. House leered back knowing he was right, but nothing would be done about it.


	8. Chapter 8

Cameron wasn't having a good day. It was doomed from the start. When the alarm went off at its usual time, instead of getting up she laid there for a while thinking about calling in sick. She never once thought about calling in sick, even when she was ill. Work didn't sound appealing today.

Somehow, she found the motivation to swing herself out of bed and get ready. She put on a little less make up than usual; just enough to get by. Anything more would be wasted on what looked like a crappy day.

First she had a couple hours of clinic duty, then back to diagnostics for no doubt more work on Chase's patient. She arrived a little late, not too late for her shift, but right on time which was strange for her. She thought about showing up when she wanted just like House, but she wasn't ready to go that far even in her somber mood.

While going through mundane run of ailments in the clinic that morning, she tried to think about what was bothering her. She concluded by pure reason that the recent changes must be affecting her way more than she initially thought. There was nothing wrong with House being in charge and the rest of them following his lead. Why did that need to change? She knew the answer, so it was crazy for her to even ask herself that. Life goes on, people move ahead. Why can't she?

After the clinic shift Cameron slowly worked her way back to diagnostics. _Oh what utter joy to be a doctor today,_ she acerbically thought. She wasn't prepared to find House standing there with white board marker in hand ready to start. She glanced across the table to share a look with Foreman who already absorbed his own surprise.

"What happened to your…?"

"Enough, I already had to explain it to Chase earlier. I'm back, get over it." House replied. "We need to talk about the future of our department."

"Shouldn't Chase be here?" asked Foreman.

"I'll have a different talk with him during our next secret meeting of the attendings only club. Anyway, it seems that our case load is going to be increased now. More will be expected from both of you. Chase and I will be running our own cases simultaneously and your time will be divided."

"How did this happen?" asked Cameron. "Did Cuddy approve this?"

"This was Cuddy's idea. If I had my way all of the cases would be going to Chase so I could sit there and watch all of you have at it. Blame Chase; I know I am. He had to go and do a great job on his case and now Cuddy thinks we can build this mega diagnostics department for all."

"Cuddy thinks he did a great job?" asked a surprised Cameron.

"Cuddy thinks he can walk on water now. Boy is she up for a major let down." House said sarcastically.

House then paused seriously to get back to the point of this conversation. "No, now is the time to officially step up. Cuddy's idea could likely go nowhere since her entire plan rests on both myself and Chase. That has disaster written all over it. However, opportunities could happen, and for two career-oriented doctors with huge ambitions it might be a chance to make something happen here. In other words, if you want to use diagnostics as a career move, now is the time to do it."

Foreman smiled at House over the prospect. Cameron looked down frowning and unsure.

"You two have to remember though that no matter what, you both still report to me and only to me. You have a problem with any case, mine or Chase's, you bring it to me. I'm still responsible for everything that happens in this department."

Cameron and Foreman both nodded in agreement.

"Of course I won't guarantee cooperation, but try anyway," said House. "Okay, it seems I don't have a case yet. How nice of Cuddy to take it easy on me on my first day back from vacation. Both of you need to do consults on Chase's patient, so now would be a good time."

Cameron glumly got up and left without saying a word. Foreman stuck behind to talk to House.

"What's up with her?" House asked Foreman.

"She isn't taking the transition very well," replied Foreman.

"She doesn't take anything well," countered House. "I just don't understand people that are miserable all the time."

Foreman flashed House a look of disapproval over the mocking comment. "You really think that Cuddy sees growth potential in this department?" he asked. "It has been just you for so long, why now?"

"Chase did so well and Cuddy actually believed he was the weakest of you three. If he could do it, then she thinks all of you can. That makes for a nice department to build a reputation with, especially since there are so few hospitals out there with diagnostic specialists. Hospital administrators and their hidden agendas. It sickens me."

"He's not the weakest," said Foreman.

"No, he isn't. I think you and I both know where the main problem with Cuddy's plan is." House pointed his head in direction of the hallway, where Cameron was standing examining a file.

"You still don't respect Chase," House continued. "How much of that will be a problem going forward?"

"I'm okay with it. Business is business and I won't let it interfere. I also have the luxury of time to see how this all plays out." Foreman candidly replied.

"I wish I could assure you it would be worth your while, because I don't know at this point if it will even be worth my while. There's certainly potential for administrative responsibilities since neither Chase nor I give a damn about managing a department. Cuddy did mention the term 'other doctors'."

That notion interested Foreman further. "I'll keep an open mind."

------------------------------

"Mrs. Anderson?"

"Yes," she replied.

"I'm Dr. Foreman. I work with Dr. Chase and will be performing a neurological consult."

"I have seen my fair share of neurologists," replied Estelle. "The last one told me..no I don't remember what the last one told me. It all becomes a blur after a while."

"How did you end up seeing so many doctors? I have to admit, I'm curious." Foreman asked.

"Usually people I work with would recommend one. There are so many bad doctors out there. I remember when my knee was hurting, it took me a couple of doctors to prescribe something for the pain, and that was usually after I had to pester them. One actually said my knees would only get better if I lost weight and gave up my job. He wouldn't prescribe any diet or pain pills though, so I had to find another doctor that would."

"All those drugs together aren't good for you. There are always alternate options to medication, especially for arthritis."

"That's what that young British doctor told me."

"He's Australian," replied Foreman with a little laugh. "He gets that all the time."

"He seems to be a nice, pretty young guy. What was his name again?" Estelle said in total confusion.

Foreman was slightly alarmed by her inability to remember her doctor's name. It confirmed what he suspected might be happening based on the MRI scan. "That's Dr. Chase. He's the one in charge of your care."

"Oh yes, that's right. You did say that earlier, didn't you?"

"Did any of the neurologists you spoke to look into memory problems?" asked Foreman.

"I'm not sure. I haven't seen one in a few years."

"We can't find any history that you have seen one at all. Did any of your doctors try to address it?"

"Sure, my psychiatrist," she replied. "He figured it was due to my depression and thyroid issues and gave me medication for it."

"Tell me about your head injury when you were a teenager," Foreman asked, trying to untangle more of the mysterious background that so occupied Chase for the last several days.

"I have always been bad with physical coordination. I was the only kid on the block that couldn't jump rope. I wanted to get real dressed up for the dance one night and put on those stiletto high heels. I was determined to look extra special since all the girls were wearing them. I started walking down the stairs, snagged the heel on the carpet and tumbled down the stairs. Next thing I remember I woke up in my bed with my mother sitting next to me."

"They didn't take you to a hospital?" a surprised Foreman asked.

"Heavens no. We lived in a very poor part of rural Pennsylvania. We couldn't afford food and clothing, let alone a doctor."

"No one noticed changes in your behavior, ability to make decisions, or anything different? Head injuries often require some type of rehabilitation therapy."

"No, because back then no one knew what a bumped head meant," replied Estelle. "I didn't die and I could walk and talk. That is all that mattered."

"I'm surprised that no one ordered an MRI or CAT scan of your brain before now. Are you sure you never been had one done?" Foreman asked.

"I had some sort of scan once, like an xray. A doctor suggested an MRI, but I'm very claustrophobic and wouldn't do it."

"There are open MRI machines. No one suggested that?"

"The doctor said it wasn't as effective so the scan would be just as good," Estelle commented. Foreman was rather impressed how well prepared she was with excuses. Too bad she was light on various information.

"That must have been a few years ago because they have gotten much better," observed Foreman. "A CAT scan wouldn't have shown in detail the abnormalities we got from the MRI from a couple of days ago. We now have a pretty good idea of what is happening. I just have nothing prior to compare it to. Another thing we noticed on the MRI was small blood clot in your brain. We will have to fix that soon. I'm hoping it will be a simple and quick procedure that Dr. Chase can perform."

"One of my doctors told me I was at risk for a stroke and put me on blood thinners. They didn't work?"

"They don't shrink the clot. They just make the flow of blood easier."

"I didn't know that. I never asked what the pills actually did. I couldn't keep it all straight. I figured it was all good."

"Thank you Mrs. Anderson," Foreman said as he got up to leave. "You have given me what I need to know."

"Pleasure meeting you Dr. Foreman," Estelle replied.

Foreman knew it wasn't a good sign that she could remember his name and not Chase's, as well as remember some details about doctor visits and not others. It confirmed his diagnosis. It was time to have a serious talk with Chase.

-------------

Cameron came back to the conference room to check some email. She needed something to do to help her with her blue funk. She was just nasty to a patient that so deserved it, but she knew to bite her tongue in those situations. She just wasn't in the mood for self-control today.

"I blame myself," House said as he walked into the room after noticing her alone. "I haven't pushed you hard enough."

Cameron was a little surprised by the candid delivery, but not phased. "You challenge me all the time, plus you always manage to deliver one nasty and degrading comment after another. How could you push harder?"

"I have humored you for too long, waiting for you to take yourself seriously. Instead all I get is this emotional crap. I spent all my good abuse on Chase. I should have saved some for you too. I let you think you were extraordinary."

Cameron was unimpressed by his admission of fault. She wasn't in the mood for patronizing right now. "I'm assuming this is regarding Cuddy's plan for the department. I thought we covered your concerns in my review."

"We are going through it again. I want to be sure we are exactly clear on where you stand." House replied.

"If I recall correctly, you hired me because I was pretty," said Cameron, who by this time was feeling very edgy. "You even told me I didn't have to work hard because of my looks and chastised me for doing so anyway. So, being pretty was enough to get me a job, but not a promotion? What happened, did you grow tired of me?"

"Don't give me that," House fired back. "You have never wanted to be judged on your looks. The idea offends you to no end. You want to be judged on your merits. Here I am, giving you what you want. You aren't measuring up."

"You promoted Chase even though he was a total screw up. I'm willing to bet he was judged on his looks." Cameron was in full attack mode now.

"There you go, doing exactly what is holding you back. You respond to adversity with immaturity instead of acting like an adult. Just grow up." House scolded. "This isn't about Chase or Foreman, and the fact that you still don't realize that each member of the team doesn't get judged the same tells me you still have learned nothing from me. I can't pull your head out of your ass for you."

Cameron scoffed at House, thus indicating to him that she was taking his criticism with full belief that he was just being an ass.

"The fact is it has been over a year and a half and you have not learned what you should," continued House. "You are tougher, but not tough enough. You still have those high moral double standards that get in the way of doing your job. You still are too emotionally attached to where you are a prime candidate for burnout by the time you are forty. If you haven't learned by now from watching me, Foreman, and yes even Chase, then you never will."

"So this is you pushing harder?" Cameron asked angrily.

"No, this is me giving up. Time to make other plans."

House left the office abruptly leaving Cameron alone in shock. She had pushed House's buttons before, but she never pushed him this far. He was trying to show somewhat skewed humility and she responded by being a bitch. Maybe it was time to make other plans.


	9. Chapter 9

Foreman saw Chase alone in the office. He knew what he was going to mention was hard for any doctor to deal with, especially the first case.

"We need to talk about your patient," said a rather subdued Foreman.

Chase looked at him with careful attention. He could tell it was something important. "Sure, go ahead."

"I had a chance to talk with Estelle and knew something wasn't quite right," Foreman continued. "Then I read the notes of the psych consult."

"Yeah, I saw those too. They didn't look promising." Chase acknowledged.

"She has dementia. The MRI shows that the areas of her brain that control memory, problem solving, and decision-making is degrading. It will not get better, and if anything it will get worse. The results of the psychological exams also support the diagnosis. She couldn't remember your name when I talked to her."

"Any chance that it is Alzheimer's?" asked a rather concerned Chase.

"It is too early to tell," replied Foreman. "It would take a long time of monitoring and memory testing to know for sure. If aphasia, disorientation, and disinhibition start happening then she should be tested, but in the meantime I have no reason to suspect it."

Chase silently listened, knowing where Foreman was going with this.

Foreman continued. "Put that with the psych consult and your home visit, it is clear that she cannot properly care for herself. She has too many physical problems that require special attention."

"I need to declare her incompetent," replied Chase.

Foreman nodded. "Is her son the appointed guardian in her living will?"

"Yes," replied Chase. "Getting him to cooperate though won't be easy."

"I can help you talk with him. There is a process he will need to follow, but he shouldn't have any trouble getting her the care she needs. Once he realizes that, he might be more willing to cooperate."

"You had to do this with your mother, right?" Chase asked.

Foreman nodded. "Although I was helping my dad. It is a little harder to do it alone."

Chase sadly nodded. "I'll also have to tell Estelle. I don't trust her son to deliver the news tactfully." Chase halted briefly to think about what he would say to Estelle. It was a lot easier for him to tell someone they were going to die than they had to spend the rest of their life in a home. That was a slow, painful death sentence to many.

"Just let me know when you are ready to talk to her son," said Foreman.

"Thanks," Chase said earnestly. "I appreciate the help."

-----------

House stood on the balcony outside Wilson's office. He was hoping Wilson would see him there and come out to talk. When Wilson noticed but chose to ignore him anyway, House impatiently walked over and opened the glass door.

"Hello, friend out here calmly waiting for you to notice."

"Oh, you are talking to me now," replied Wilson. "Of course you are, you have that look that you need to bend my ear or you will explode. Apology accepted I guess." Wilson then got up and joined House out on the balcony.

"So what is so important this time? Did you kill someone?" said Wilson. Then the light-bulb-flash moment hit him when he took another glance at House. "No, you have a problem with one of your subordinates."

"I yelled at Cameron," House said rather ashamed at himself.

"Did you make her cry?" asked Wilson

"No."

"Then things are okay. She'll go around pouting for a little while and then she'll be back to falling all over you in no time."

"I told her it was time to make other plans," House said with minor remorse. "I really smacked her down this time."

"Oh, come on. You have given her more than enough chances. You are just having feelings of guilt because she is a beautiful woman and she has your number."

"What is that supposed to mean?" asked House. "She doesn't have control over me. If anything, it is the other way around. She would jump off a cliff if I told her too. Of course she would bitch about it before hand, but she would do it."

"It isn't about control," explained Wilson. "You let that pretty face prevent you from dishing out the necessary amount of abuse she needed to get over her many hang ups. If I recall, your over abuse of Chase didn't get the desired reaction either and he seems to be turning out just fine. So why are you so worried about Cameron? She'll find her own way when pushed."

"That's the problem," replied House, "I don't think she will. She has responded to the latest changes by whipping out her closet of deep fear and insecurity. I find that troubling."

"She has always been that way. What made you think she would change now? Oh, I see why, because Cuddy is forcing you to make decisions regarding their futures. They are no longer around for your amusement. You actually believed when this time came she would rise up."

"I thought all of them would rise up," House confessed.

"Why, because you are such a great mentor?" Wilson said mockingly. "You can't make people get a clue. Cameron really has come a long way if you think about it. You did harden her a lot. Too bad she never got over the hero worship."

"I was too soft on her because she is a beautiful woman. I figured that was all she needed to get by. It turned out I was really wrong. Now she has too far to go in such a short time."

"All doctors are deeply insecure." Wilson observed. "We should be. We are playing with the knowledge that one wrong move and the essence of a life is gone. What makes Cameron different is that she wears her insecurities and heart on her sleeve. She must figure out for herself that continuing to do so in this profession will consume her. There's nothing you can do to fix that."

"In other words, once she grows some balls, she'll be fine."

Wilson laughed. House always had a gift of breaking down his sensitive view of things into more real world terms. "Yes, that is one way of putting it."

"I wonder if I should talk to her again. I was pretty harsh." House was still feeling a little guilty.

"No, what you did was great," answered Wilson. "She needed a kick in the ass from you. Maybe she'll finally get over all those feelings of admiration. In the meantime, Chase will nurse those hurt feelings."

House looked at Wilson rather surprised by his conclusion. "No way she'll go to him this time. He is a big cause of her angst right now."

"Come on, you are in complete denial if you think that. She is now distraught and will go running to a source of comfort. Chase has always been her outlet. One look at her waifish pout and he will melt into playing the 'good guy friend there to help' role that he is so good at. While she is whining about how unfair her life is, he will sit there listening while looking at her with an adoring gaze. You know that look, the same gaze you give her most of the time."

House flashed Wilson an intense look of disapproval over his comment.

Wilson got a huge devilish smile. "It was a joke! Why House, do I sense some jealously of your junior attending over the fair maiden? I wouldn't go down that path if I were you. He is already one step ahead of you. You got a date, he got to sleep with her."

"Are you going anywhere with this?" asked House still bothered. "He can comfort her all he wants. It isn't going to help her grow up like she should."

"Just let it go," Wilson advised. "It will all work itself out. If Cameron can't get over her hang ups, she'll move on like she should. I have a feeling though that Chase will convince her to try. Strangely, he likes having her around even though he knows he'll never get to touch her again."

"Oh, they'll do it again," said House.

"You know this for sure," Wilson said skeptically. "Ah yes, that is because of your profound and wise understanding of the human infatuation with sex."

"Those two are so weak," explained House. "All it will take is one moment of strife and they will remember how great it was and how it won't hurt to have a little tension release one more time."

"How do you know it was great?" Wilson asked curiously.

"It is so obvious. Afterward they didn't have looks of shame or embarrassment. They flashed each other subtle smiles before deciding that trying again would be a very bad idea."

"So you will be okay with such behavior continuing with your professional staff?"

"It's only sex. It doesn't mean anything." House replied.

Wilson started chuckling. "You should really write a book on your management techniques. I could see them being adopted by every boardroom in the country. Break their will, unfairly favor one over another, and encourage lots of casual sex among members of your team."

"It's more like dazzle them with your shock and awe when breaking their will while they are having sex." House said with a big smile and joking tone. "You are right, I can make millions on this."

Wilson laughed along with him. They both needed a humorous moment at this particular time.

"Thanks," said House. "She has four months. I guess we will see what happens."

----------------------------------------

"So what is wrong with my mother now?" Mr. Anderson asked when both Chase and Foreman were there to meet with him.

"This is Dr. Foreman," Chase replied. He is a neurologist that has examined your mother."

"Another doctor, that is great. So what new defect have you found?"

Foreman understood completely where the anger was coming from, but he also knew better than to put up with this guy's attitude. "I know you are bitter, but this is the only mother you have. Care to know what is going on?"

Mr. Anderson nodded. "Sorry, but you don't know what crap that woman has put me through. It's like caring for a small child."

Chase and Foreman looked at each other acknowledging that this wasn't going to be easy.

"Please, let's have a seat," Foreman said as he motioned to the available seating in the private waiting area.

"Mr. Anderson," Chase started, "We have been examining your mother thoroughly to make sure we clearly understand all her physical and mental problems and treat them properly. In identifying all the conditions, we found enough evidence to conclude she can no longer make sound decisions on her own. She is going to require constant medical attention that she cannot provide for herself."

Mr. Anderson looked at him kind of confused, not sure where Chase was going with all the information he was sharing.

"You are going to have to evoke power of attorney," continued Chase. "She needs to be admitted to an assisted living facility. We cannot permit her to go back to her home."

"Oh, no way," replied Mr. Anderson. "There is no way I'm taking over that mess. She will drag me down with her. She can't go home anyway. You had her place condemned."

"You are listed are her legal guardian in her living will," replied Chase. "There is no one else that can care for her."

"Too bad. Make the state care for her or something. I don't need to be taken down by her problems anymore than I already have."

Foreman jumped in. "Okay, now it is time for you to carefully listen to what we have to say. No more objecting until you know all the facts. No matter what entitlements you think you have in this world, one of our primary responsibilities as children and human beings is to care for our parents when they can no longer care for themselves."

"You don't know all the trouble I have had to go through with this woman. I have had to help her with harassment from bill collectors, file accident insurance claims, pick up prescriptions and pay for them because she had no money to get them not to mention listen to her ramble about nothing on the phone daily. I'm too young to have to care for a parent like this. My dad is fine."

"Sorry this is happening to you at a much earlier age than you thought it should, but see it as getting it out of the way while you are young," replied Foreman aggressively. "You have enough energy and time to do this now. Your mother needs you, and that is all there is to it. You don't have much of a choice here."

"Oh and I suppose both of you have had to care for your mothers by now." Mr. Anderson replied in a derisive tone.

"As a matter of fact yes, both of us have," replied Foreman. "That is why we are here to help. All you have to do now is take it."

Chase was very surprised to hear Foreman declare that both of them had been through this. It was a personal fact he didn't know Foreman was aware of. When Mr. Anderson looked at him, Chase's stare acknowledged that what Foreman said was true. Then the young man looked at Foreman to see he was being sincere as well.

"Okay," said Mr. Anderson reluctantly submitting. "I guess I knew this was going to happen eventually. What do I need to do?"

"We will have a social worker contact you that specializes in helping families find adequate facilities for loved ones that require specialized care," replied Foreman. "There are several options for Medicare only facilities out there since your mother doesn't have any financial means to support herself."

"My grandmother was in a good one a few years ago back in Pennsylvania. If I can get her in there, she will at least have family nearby."

"Okay, that is a great start," replied Foreman is a more passive voice. "Dr. Chase here will be filing the paperwork you will need to take over power of attorney and get her transferred. If you need anything else from either of us, don't hesitate to call."

"She won't be discharged for at least another week or two because she has to have surgery," said Chase. "Once she is able to be transferred, an ambulance will transport her to where she will get her care. We will make sure all her conditions have been treated and properly medicated before she is moved."

"So no more of 20 different medications from 20 different doctors?" asked Mr. Anderson.

"No, she will be under the care of one primary physician at the facility. They will control the meds she gets from now on." Chase replied.

"So all I need to do is get her into a home and someone else will care for her? I only have to file her taxes and stuff like that?"

"Yes that is all, although she might appreciate a visit once in a while," Foreman said adding his own personal insight to the conversation.

"Who is going to tell her? Mr. Anderson asked. "She won't take this well at all."

"I will," volunteered Chase.

"Okay, I think I can do this then." Mr. Anderson replied having calmed down by now. "Thanks, and I'm sorry I can be difficult at times. My mother drives me crazy most of the time."

Foreman smiled. "Someone will be in contact with you soon."

As Chase and Foreman walked away, Chase couldn't help but appreciate the use of hostility. "You see," said Chase, "there are times when arrogance comes in handy. Glad to see you can use it when needed."

"Someone had to do that to me believe it or not," Foreman replied. "It worked."


	10. Chapter 10

Estelle's son had delivered on his promise. Within a few days, he was able to get his mother into the same facility his grandmother had lived. It was actually pretty easy. Estelle often visited with the other patients and delighted the staff with her warm continual presence while her mother was there. They all knew her very well and wanted to return the favor.

Chase now had the task of telling Estelle what was about to happen. She was getting much stronger and had surgery scheduled the morning after tomorrow. She needed time to prepare herself for the dramatic changes in her life, so today was the day she needed to be told.

"Good morning Mrs. Anderson," Chase said delivering a smile as he entered the room.

"Oh, there is that lovely smile on that pretty doctor again," she replied. "I'm never going to get tired of seeing that."

Chase grabbed a chair, pulled it next to the bed and sat down. "You are finally done with one doctor after another coming in here. We have a very good idea of what all your issues are and how to treat them."

"Too bad," Estelle replied jokingly. "I was actually enjoying all the attention."

"You are scheduled for surgery the morning after tomorrow," Chase started. "There are a few benign tumors that we need to get out of your liver and kidneys, and we will take care of that clot in your brain. We also found a herniated disk in the middle of your back that will be removed and the two vertebrae will be fused together."

"That doesn't sound too bad. That's all you have to do?"

"That is just what can be fixed with the surgery. After the surgery we are going to slowly start you back on some medication. You will have to go back on levothyroxine for your hypothyroidism. For your high blood pressure, I'm going to prescribe an ARB called Atacand since you have kidney issues and there is far less risk for other drug interactions. No more ACE Inhibitors for you."

Estelle looked at him attentively ready to hear the long list of other drugs/problems that would be addressed next.

"After that, the diagnosis got a little tricky. We looked at the list of symptoms that were left and found that while many of them were indicative of other conditions, there was one particular problem that they all fit into. The conclusion is that you have fibromyalgia."

"I read up on that carefully before I got sick. I was convinced I had it." Estelle confirmed.

"There is good news and bad news with that diagnosis," Chase continued. "The good news is that many of your medications can be eliminated. The bad news is, it is a painful disease in which there is no cure."

"There has to be medicines to treat it. I at least need pills for the arthritis and muscle pain."

"You don't have arthritis," replied Chase. "Muscle and joint pain caused by fibromyalgia cannot be treated the same way. The disease is also causing your rhinitis, irritable bowel, headaches, diarrhea, numbness of hands and feet, and the dizziness. You will not be given medication anymore for any of those problems. If we did put you those medications, they would interfere with one another and continue to destroy your liver."

Estelle looked very worried. "I need the medication. Without it, I'll be in constant pain."

Chase started talking in a tone of complete reassurance. "With this disease, there are methods that will work just as good if not better than any drug. There is no drug that is going to take it away. Since the depression and anxiety is linked to the fibromyalgia you will get to go back on an anti-depressant but this time one that promotes better sleep. Other than that the treatment is learning how to manage and live with pain. If the muscle pain is too bad, occasional acetaminophen will help. You will get cognitive-behavior therapy and continue frequent acupuncture sessions. "

"That can't be all there is too it." Estelle had a sense of desperation in her voice. "I need those medicines. Isn't there any other over the counter drugs or vitamins that can help?"

"All those things were poisoning your body. A carefully followed treatment plan is all you need. It all starts with sensible self-care. If you reduce stress and get enough sleep, then the pain will get better. You will also need to start doing some exercise. That will not only help with the fibromyalgia but other problems as well such as the osteoporosis. You will also need to eat healthier. Junk food will no longer be permitted regularly."

Estelle started fighting back tears. Her lower lip was quivering as she tried to understand what she was faced with. "I'm too old to be changing my habits," she said shakily.

"Mrs. Anderson, its okay to be upset. Lifestyle changes are scary, plus I know from the psychologist that many of your self-care problems are due to your low self-image. Don't worry, you will be getting help." Chase tried to be as positive as possible.

"How so? I have had to do everything by myself. No one has ever wanted to help me." Tears were slowly slipped down her face, although she was fighting them back.

Chase's heart sunk as he knew it was time to deliver the rest. "That is the other thing we have to discuss. Do you need a minute before we go on?"

Estelle took a deep breath and said in a shaky voice, "Go on, I'm ready."

"I originally thought that your memory and concentration issues were also due to the fibromyalgia. When Dr. Foreman saw you though, something else was diagnosed. You are in the early stages of dementia."

Estelle's face instantly drew looks of deep panic and alarm. "No, I can't have that. I take care of patients that have that. They can't care for themselves. I'm not like that at all. It must be the fibromyalgia."

"I'm sorry Mrs. Anderson, but the MRI showed degradation in your brain. The head injury you suffered as a teenager has slowly caused it. The psychological tests also support the diagnosis." Chase as usual was firm with his presentation of the facts so he would leave little doubt, but he knew he was breaking this woman's heart.

"Please, no, that isn't it." She replied desperately. She was fighting her emotions hard, but the look in her eyes showed that she was unable to accept such a fate. "I will do everything you say. I will start taking care of myself. When I get home I'll get rid of all the pills and only follow your instructions."

Chase looked her somberly, knowing he was about to deliver the final blow. "Estelle, you aren't going to get to go home. I had a talk with your son. I'm afraid we had to give him the legal right to exercise power of attorney. He is now going to be making decisions for you. He has arranged for you to be admitted to the same nursing care facility that your mother was in."

Estelle broke down in intense sobs. She tried to speak but had trouble. "No…don't..let..my..son.." She had to stop there.

While Estelle had her moment of falling apart, Chase remembered what he read in the psychological profile. Estelle often avoided crying and dealing with emotion. She always kept everything in. Such a release would feel so good later, but for now, it had to be very traumatic. While she continued her extreme weeping, Chase sat there holding her hand, offering a sympathetic and supporting gaze. After a few minutes she tried to talk some more, but kept having to stop because she would cry harder.

"Estelle, it is okay. You need this emotional release. Crying is the body's natural way of dealing with intense despair. It is good." Chase told her as she kept getting frustrated by not being able to control herself.

"I wouldn't let myself cry at my own mother's funeral," Estelle said with a quivering voice. "I hate crying. It always makes me feel bad. I hate feeling bad all the time. What am I going to do? My life is over. Those homes treat their patients like dirt. I won't get to have all my things there, and I can't come and go as I please. I might as well be dead."

Chase silently looked at her with deep empathy. He needed to give her another minute or two to absorb the news before saying anything else.

"No, I can't go into a home," she said, still in denial. "I need all my stuff. I can't give up everything. That is all I have. You can't take my life from me."

Chase knew what he was about to say would be more upsetting. "Unfortunately, another serious mental condition you have is called Hoarding. The collecting and piling you were doing was a serious health and fire risk. Your son let me search your home and I found toxic mold underneath all the stuff you were piling in your apartment. The place had to be condemned and all items removed."

Estelle broke into sobs again. "I'm such a failure. I have never been able to do anything right in my entire life. I'm even not allowed to go home because I'm such a crappy housekeeper."

Chase then grabbed her hand tighter and looked her straight in the eye. "It isn't bad housekeeping. You have a serious condition where you can't control your actions. That was the reason why your son got power of attorney. It is not your fault. You are finally going to get the help you need. That isn't failure. That is relief."

Estelle wasn't convinced and was still rather hysterical. "A nursing home? That is for old people that are in the last stage of their lives. I'm not that old. I'll be going there to die."

Chase gazed at his hysterical patient with deep sincerity in his blue eyes and offered an optimistic glance. "Come on, you have been working for a few years in such a place. You have done wonderful things for the patients and made many friends. You can do so as a resident and will be near family and friends again. You are just emotional right now and need time to think about it."

"I'm so scared. I don't know if I'll be able to adjust."

"Trust me," he replied, "I have had to go through a major change in my life recently. It is scary, it is hard, but it happens for a reason and you are better for it."

Estelle calmed herself down by taking deep breaths while examining the sincerity in Chase's eyes. "You are right," she said with a slightly calmer disposition. "I don't know why, but I always hear the bad and never the good. My mother was always like that too so the reaction is natural."

"You have had a lifetime of unwanted feelings and behaviors," Chase assured her. "The Cognitive-Behavioral therapy will help you with that. If you think about it, it's all good."

Estelle looked down, too emotionally exhausted to take anymore. "It might be nice to have someone finally take care of me for a change," she said in a way that she was still trying to convince herself while tears were still streaming down her face.

"Estelle, you are tired and this is a lot to take in at once." Chase calmly told her. "Why don't you get some rest. Everything will seem better after a little sleep."

She nodded wearily and didn't say anything else. She was still too distraught.

Chase put his hand on her shoulder before leaving. "It will be okay. Just give it a little time to sink in."

Estelle wasn't sure about her young doctor's view, but for right now sleep was all she wanted. She needed to slip away for a while.


	11. Chapter 11

"I can't accept you in your new role." Cameron blurted out as she saw Chase alone in the conference room.

"I can't accept me in my new role either," replied Chase. "What are we going to do about it?" Then he flashed a smile unable to keep up the serious facade.

"I'm not kidding around Chase," said Cameron.

"It will get better with time. Adjustment is hard." Cameron flashed him a scolding glare. "Okay, no more joking." he replied ready to take her seriously.

"At this point, I should probably cut my losses and move on," she said with hopeless resignation.

"Is that what you really want?" asked Chase.

"No, but that is what House wants."

"How do you know that?"

"He told me."

Chase looked at her very skeptically. She wasn't telling the entire story.

"Okay, he told me in so many words after I ticked him off. I don't know where my attitude comes from sometimes. I still don't know when to bite my tongue. I have never seen him that mad."

"He didn't mean it," replied Chase.

"Oh, he meant it. He's probably right. Maybe I'm just not ready for the huge responsibilities that we have to face now."

"That is a bunch of crap," countered Chase not buying into her "woe is me" routine. "You aren't afraid of responsibility. You are afraid of standing up to House."

"I stand up to him all the time," replied Cameron.

"No, what you do is have hissy fits over his lack of morals and complain to the point where he either humors you or avoids you so you will shut up. Have you ever really gotten what you wanted by doing that?"

"He needs to know when something he is doing is wrong, especially ethically."

"He doesn't want an ethics lesson. He knows the difference between right and wrong and decides he doesn't give a damn. Sure, we do need to let him know, often in an arrogant way, when he is going too far but once he gets the point and chooses not to listen we need to move on."

"I still don't see how my objections are hurting my career," Cameron replied unwilling to back down. "Someone needs to stand up to doctors with God complexes. He'll end up killing someone if I don't stand up for the welfare of the patient."

"I would agree with that, if we were actually talking about patients," Chase argued. "Most of your comments actually get in the way of the welfare of the patient. How about when Foreman stole your paper? What did you think was going to happen by complaining about it to everyone, especially in front of patients? You think House was going to feel sorry for you and fix things? No, all you were doing was pissing him off, and many of us around you. Your protests weren't going to change what happened, and they were making you look emotionally unstable. How was that helping the patient?"

"I don't know why you defend him," Cameron snapped back. "For over two years he has done nothing but knock you down and make you feel completely worthless. He has everyone in this hospital convinced that you are about the worst doctor that had ever lived. You are selling out because he gave you a promotion."

"Throw it back at me. I'm the bad guy now. I personally have ruined your career." Chase replied defensively. Then he stopped for just a second to talk in a slightly calmer tone. He knew being belligerent with Cameron was a no win situation. "I'm not sure why everyone thinks that I walked into this so called promotion. I'll admit, this wasn't on my career plan, but then again, I never had a career plan. I have learned to take advantage of opportunities that are in front of me whether I expect them or not. I don't defend House, I just often agree with him and I have always done that. It doesn't matter what I say though because he still makes me look like the worst doctor that ever lived. This new job changes nothing as far as I'm concerned."

"I'm sorry, you are right." Cameron said backing down. She stopped to choose her next words carefully. The conversation was getting a little antagonistic and she wanted some useful information out of this talk. "Let's be hypothetical. If you were my boss, what would you tell me to do to turn things around?"

"Oh, I'm not going there," replied Chase. "The last thing I need is you jumping down my throat at the slightest critical comment, constructive though it might be."

"I promise, I'll keep my mouth shut and listen to what you have to say." Cameron pleaded.

"I don't believe you can do that."

"Please, I'll be an adult."

Chase looked at her carefully. He had no reason to believe she was lying, but he still had doubts about her self control.

"Okay, I can't believe I'm agreeing to this." Chase looked down trying to figure out where to start. "You will never have respect if you still faithfully answer House's messages, do his scheduling and handle his mail. You are a highly skilled doctor, not his secretary. He has been waiting almost two years for you to tell him that. As long as you play into his sexist stereotypes, you will not get the opportunities you think you deserve."

"House is a sexist jerk." Cameron quickly replied.

"All doctors are sexist jerks. Even Cuddy plays that card because she has to. You have to accept such realities and know how to play them or you will never make it in medicine."

Cameron gritted her teeth, offended by the mentality of sexism in the medical profession. Still, she promised Chase she would hold back. "Point taken, go ahead," she stated calmly.

"How long do you plan on being a doctor where you actually treat patients?" Chase asked.

"Forever. I didn't work this hard not to and working in a lab all the time would drive me insane." replied Cameron.

"Then you need to learn to control your emotional reactions. Personally I think you have gotten way better with that since you got here, but you need to know when your emotions are clouding your judgment. Patients and their families respect doctors that can show empathy, but they get a little freaked out by emotional train wrecks. They need to know the doctor is in control."

Cameron stayed silent, being true to her word.

"Okay, so far so good," said Chase taking Cameron's silence as a good sign. "You are jeopardizing so far what has been a brilliant and focused career by not accepting the primary House diagnostics principle. Cure the patient. Do everything in your power to make sure that happens. Actually, he cares more about the disease than the patient, but you do score points for not killing someone. He doesn't even care if you make mistakes in the process. You just need to do everything you can to reach that goal, even if it means stretching yourself."

"Yes and where I can't stretch, that is where my team comes in. He covered that well in my last review."

"He may have covered it, but he doesn't think you believe it. I don't think you do either just by the roadblocks you put up all the time. Until you jump in and change that perception, you will always be weak in his mind."

"Changing perception is not easy." Cameron observed.

"Trust me, I know. Perception in our group is especially hard when you, me and Foreman spend too much time trying to tell whether House is using his cruel and erratic antics as a way to teach us or for his own personal amusement."

"You got that one right," Cameron replied jadedly.

Chase continued. "I would be remiss if I didn't point out your exceptional qualities. After all, I'm not one to break spirits like House. You are a brilliant doctor and your abilities in diagnosis are outstanding. When you aren't judging them, the patients and their families like you and feel comfortable around you. I personally think that you considering other options would be a great loss to this team, but I also don't want to see you hold yourself back. Working for House longer term may not be the career move you dream of. There are no high honors, praise, glory or achievement as long as he is your boss."

Cameron sat down, taking some time to absorb the comments. Despite all that was said, there was still one thing that was missing. "Chase, do you find your career personally fulfilling?" she asked.

"Yes."

"Really? You really believe that your career is offering everything you need?"

"Until something better or different comes along, yes, this is all I need."

"I thought that being a doctor, a highly prominent and well respected doctor, was all I needed. It was everything to me and I worked so hard to get where I am now. Now that I've gone this far, it all feels so empty. Probably because all I ever hear is how everybody lies and see how so many people are deceptive to each other. It all makes me sick."

"House thinks your greatest weakness is your clouded view of the human condition," Chase commented. "He so wants to put a major kink into that view. There is good out there, but the reality is that humanity is cruel. Being a doctor exposes you more to that reality than any other profession. You can't change human nature no matter how hard you try. The harder you do try the more disappointment you are setting yourself up for."

"How can you live accepting that?" asked Cameron. "Having that cynical view of humanity would consume me."

"Having a rose colored view is already consuming you," replied Chase. "You need to find your balance. That is called life."

Cameron took a deep breath in utter frustration. She didn't know what to think. "I'm not sure I'll ever find happiness."

"Happiness, that is a different story." Chase said with raised eyebrows. "You asked about fulfillment. Just about everyone you work with is very fulfilled with their careers." Then he looked at her straight in the eye. "None of us are happy."

Chase then walked away, where a stunned Cameron stood alone to grasp that notion.

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"So Estelle is leaving today," Foreman asked Chase as he saw him standing in the clinic lobby.

"Yes," replied Chase. "Everything looks good post op and for once the medicines seem to be working. She even admits that she has less pain now than she ever did."

"Physical pain, how is her emotional state?" Foreman asked with concern.

"Today seems better. She was deeply depressed the last few days, but the psychologist has been working on positive thinking exercises. They finally seem to be helping."

"Is her son going with her in the ambulance?"

"No," replied Chase, "He is already at the center getting things ready there. There will be a good amount of family there to welcome her when she arrives.

"I'm going to stop by right now then and wish her luck." Foreman said.

"Tell her I'll be there in a half hour to take her down to the ambulance." Chase replied.

Foreman nodded and started heading toward the elevator. After a few steps he paused, turned around, and said to Chase, "Despite all that will happen, she will never forget her gratitude for what you did for her."

Chase gave a slight look of appreciation to Foreman as he headed back toward the elevator.

---------------------------------------

Chase arrived in Estelle's room a half hour later delivering on his promise to take her downstairs. The nurses already had her in the wheelchair with all items packed. There she sat with a smile on her face.

"It looks like you are doing much better today," Chase told Estelle. "You ready now?"

"Yes, I'm more than ready. I want to get started." Estelle optimistically replied.

"I'm sure you are really glad to be leaving here," Chase told Estelle as he started to wheel her down the hall. "This place gets on everyone's nerves after a few weeks."

"Yes, I never knew how much I missed my family," Estelle replied. "I talked to my sister last night. She assured me that everything would be in its perfect place by the time I got there. She was always so good to me. I don't know why I didn't talk to her more often."

"Distance has a way of keeping you away from those that care. In times of crisis though, you learn quickly who you can count on, no matter how far away." Chase observed.

"I'll have to consider that to be a fact then, since you know a lot about distance," replied Estelle. "I looked up Australia on the map. It is on the exact opposite side of the world. How did you end up here?"

"I wonder myself," Chase replied.

They arrived at the entrance where the ambulance was waiting for them. Chase turned toward Estelle and looked at her with intense sincerity. "I wish you nothing but the best," he said.

"I have never met anybody that has cared about my welfare so much," Estelle said emotionally. "I'm not sure why God finally sent you now. I could have used you years ago."

Chase accepted her comments with a small smile. "I have to admit, I question God's timing quite a bit myself."

"Thank you Dr. Chase. I'm very grateful."

Chase gave Estelle an assuring glance as they loaded her into the ambulance. He turned around and started walking back through the hospital corridor. He had to admit, that bee sting was likely the best thing that ever happened to her.

"Chase!" a voice rang loudly from the other end of the hallway.

He looked over to see House limping along carrying two files.

"Patient gone?" House asked.

"Yep, she's officially discharged."

"Great, we have two new cases. You get this one." He handed Chase the file.

"An old executive that gave us some money," House explained. "Cuddy is personally overseeing his care so don't screw up. It looks rather routine and boring, your type of case."

"You said two cases." Chase inquired.

"This one is mine," House said as he held up the file. "Gorgeous young blonde woman with a bad tummy ache. She gets to tell Dr. House where it hurts. Good luck with the old guy's prostate. If you need help, ask Cameron."

As House left Chase alone in the hall holding the file of his new case, Chase let a small smile slip. Things were finally getting back to normal.

_The End_

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**Thank you so much for taking your time to read and send comments for both this story and A House Assessment. The reactions have been wonderful. I had no idea that a simple idea about performance reviews would go this far. The things we can come up with waiting for the new season to begin. **

**Any future sequels will likely involve Cameron resolving her career issues, so we will see what comes of that. **

**Thanks again everybody! This has been a great experience.**


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